Big Ideas 2017

Nick Zwar

Health care systems worldwide are organised, delivered and funded to provide services to people who feel sick rather than help keep people well. This is a fundamental challenge when many of the conditions that cause disease and death such as heart attack and stroke are the consequences of risk factors that have no symptoms. High blood pressure is a good example. To make matters worse the people who have the most to gain from prevention are often hiding from health care and seldom come to see a doctor due to health literacy, cost or other barriers – the so called inverse care law. This presentation describes a new approach where people at high risk of cardiovascular disease are identified through searching computerised medical records and are offered a series of visits with the practice nurse and their GP so that their blood pressure and other cardiovascular risk factors can be actively managed. The results so far show that seeking out those hiding from health care leads to substantial improvement in blood pressure that should translate into fewer deaths from heart attack and stroke.


Professor Zwar is a graduate from University of Adelaide. He has worked for ten years in the inner west of Sydney as a GP while also working as a medical educator for the Royal Australian College of General Practitioners. He completed a Masters of Public Health at the University of Sydney as well as a PhD at University of Newcastle.
His research at the University of Wollongong is focused in the following areas: Chronic disease management in general practice and primary health care; health promotion in primary care; and, cardiovascular disease, travel medicine, quality use of medicines.

Connect with Nick on Twitter: @nickzwar

Last reviewed: 14 June, 2017