Biomedical risk factors is an Australia's health topic

Biomedical risk factors are bodily states that have an impact on a person’s risk of disease. There are a few biomedical risk factors that contribute to the risk of developing chronic health conditions. Biomedical risk factors outlined in the National Preventive Health Strategy 2021–2030 include:

  • high or low blood pressure
  • high blood glucose levels
  • overweight or obesity, and underweight (see Overweight and obesity)
  • high blood cholesterol
  • genetics, epigenetics, and telomere biology (Department of Health 2021).

Biomedical risk factors are closely related to behavioural risk factors such as tobacco use and dietary risk factors (Department of Health 2021). They may also be affected by other determinants of health including social, commercial, and environmental determinants. For more information, see What are determinants of health?

This page focuses on 3 biomedical risk factors: high blood glucose, high blood pressure and high blood lipids – which have been directly linked to specific health outcomes such as cardiovascular disease, including coronary heart disease and stroke, chronic kidney disease and diabetes. Overweight and obesity are discussed in Overweight and obesity.

The Australian Bureau of Statistics (ABS) National Health Survey (NHS) is run approximately every 3 years and collects information on both self-reported and measured data. The most recent survey was run in 2022.

National measured data on cholesterol and blood glucose were collected in the Australian Health Survey (AHS) in 2011–12. The ABS is collecting new data on these measures as part of the Intergenerational Health and Mental Health Study; National Health Measures Survey from 2022 to 2024 (ABS 2023d).

Key messages

Blood glucose

  • High blood plasma glucose (including diabetes) was responsible for 4.3% of ill health and premature death in Australia and was the fifth leading risk factor contributing to ill health and premature death in 2018.
  • 0.6% of adults (without reported diabetes) had ever been told by a doctor or nurse that they have high glucose in their blood or urine in 2022 – similar to in 2017–18 (0.5%).
  • 3.1% of adults were at risk of diabetes with measured impaired fasting glucose in 2011-12.

Blood pressure

  • High blood pressure was responsible for 5.1% of the ill health and premature death in Australia and was the fourth leading risk factor contributing to ill health and premature death in 2018. High blood pressure contributed to a higher proportion of fatal burden (8.1%) than non-fatal burden (2.3%).
  • In 2022, 14.9% of adults reported they had ever been told by a doctor or nurse they have high blood pressure or hypertension – similar to 2014–15 (14.6%) but higher than 2017–18 (13.6%).
  • 23.3% of adults had high blood pressure measured in 2022 – higher than in 2011–12 (21.5%). After adjusting for the effects of age, the rate of measured high blood pressure has remained similar over the last decade. 
  • Of those adults who had high blood pressure measured, 74.5% did not report having hypertension or high blood pressure in 2022 – similar to 2011–12 (71.9%).
  • In 2017–18, 34% of adults had measured high blood pressure and/or were taking blood pressure medication. Of these, 32% had their blood pressure controlled with medication (AIHW analysis of ABS 2019). 

Blood lipids (cholesterol and triglycerides)

  • High cholesterol levels were responsible for 2.7% of ill health and premature death and contributed to 37% of the total coronary heart disease burden and 16% of the ill health and premature death from stroke in 2018. 
  • In 2022, 10.7% of adults reported they had ever been told by a doctor or nurse they have high cholesterol – higher than 2017–18 (7.8% of adults).
  • 32.8% of adults had high cholesterol measured in 2011–12.
  • 63.2% of Australian adults had dyslipidaemia or blood lipids outside of the healthy range in 2011–12. This included 56.6% with uncontrolled dyslipidaemia and 6.6% with normal blood lipid levels who were taking lipid-modifying medication.

Multiple biomedical risk factors 

  • 1 in 4 (25%) Australian adults had both high blood pressure and dyslipidaemia in 2011–12.

Blood glucose

The inability to regulate blood glucose is a characteristic of diabetes (see glossary) and the initial stages of type 2 diabetes, also known as pre-diabetes.

A person may not currently have diabetes but record higher than normal glucose levels, either in the fasting or non-fasting state, placing them at significant risk of diabetes. This includes impaired fasting glucose (see glossary) and impaired glucose tolerance (see glossary).

It is also possible for blood sugar to become too low (hypoglycaemia). This can occur in people with diabetes if they have taken too much medication, have not eaten enough or have been more active than usual, and can be life threatening if not treated (Diabetes Australia n.d.; Health Direct n.d.).

Burden of high blood plasma glucose (including diabetes)

High blood plasma glucose (including diabetes) was responsible for 4.3% of the total burden of ill health and premature death and was the fifth leading risk factor in Australia in 2018 (AIHW 2021). Burden of disease measures the impact of living with illness and injury and dying prematurely (see glossary). This is reported on by the AIHW Australian Burden of Disease Studies, see Burden of disease. High blood plasma glucose includes the direct and indirect health effects of type 1 diabetes, type 2 diabetes, other diabetes, and high blood plasma glucose (Figure 1).

Type 2 diabetes contributes 2.2% of the total burden of disease in Australia (Figure 1). More than half of the high blood plasma glucose attributable burden is from the direct health effects of type 2 diabetes. Much of this burden can be prevented by addressing health determinants (see glossary) which lead to risk factors for type 2 diabetes. Risk factors include overweight and obesity, dietary risks, insufficient physical activity, air pollution, tobacco smoking, high blood pressure and excess alcohol intake. 

For more information on diabetes, see Diabetes: Australian facts, Diabetes risk factors. 

Figure 1: Burden of disease directly and indirectly attributable to high blood plasma glucose in 2018

Figure shows 4.3% of the total burden of disease is due to high blood plasma glucose, due to the direct and indirect health effects of type 1 diabetes, type 2 diabetes, other diabetes and high blood plasma glucose.

Note: High blood plasma glucose is defined as per the Australian Burden of Disease Study (AIHW 2021)

Source: AIHW 2021, 2023.

Self-reported data on impaired fasting plasma glucose

In 2022, among adults (aged 18 and over), 0.6% reported having high glucose levels measured in their blood or urine, this does not include people who have been told by a doctor or nurse they have diabetes (ABS 2023e). This is similar to 2017–18 (0.5% of adults) (AIHW analysis of ABS 2019). Men (0.5%) and women (0.6%) reported similar levels of having high glucose levels measured in their blood or urine (ABS 2023e).

Measured data on impaired fasting plasma glucose

Self-reported data underestimate the true impact of impaired glucose regulation in the population, as many people are unaware they have impaired glucose regulation. In the 2011–12 National Health Measures Survey, impaired glucose regulation was assessed via measurement of fasting plasma glucose levels. The proportion of adults (aged 18 and over) who were identified in 2011–12 as being at high risk of diabetes with impaired fasting plasma glucose was 3.1%. This was higher among men (4.1%) than women (2.1%) (ABS 2013a).

The proportion of adults with measured impaired fasting glucose generally increased with increasing age and was highest among people aged 75 and over (7.5%) compared with those aged 35–44 (2.1%) (ABS 2013a).

Blood pressure

High blood pressure – also known as hypertension (see glossary) – is a risk factor for chronic conditions, including stroke, coronary heart disease, dementia and chronic kidney disease.

High blood pressure is defined as when the systolic blood pressure is greater than or equal to 140 mmHg, and/or diastolic blood pressure is greater than or equal to 90 mmHg. Hypertension is a diagnosed medical condition where your blood pressure is consistently high, a single high measurement indicates a need for further medical follow up. Generally, if you have a high blood pressure reading taken on at least 2 separate days by a health professional, you may have a diagnosis of hypertension (Health Direct n.d.; Heart Foundation n.d).

Treatment of high blood pressure is usually through a healthy diet, keeping active, avoiding smoking and taking medication. Well controlled high blood pressure means your blood pressure measurements are in the normal range – if the systolic blood pressure is less than 130 mmHg and/or diastolic blood pressure is less than 80 mmHg. A doctor will advise patients what their ideal blood pressure should be, based on their medical history (Health Direct n.d.; Heart Foundation n.d.).

Burden of high blood pressure

High blood pressure is the fourth leading risk factor contributing to 5.1% of ill health and premature death (total burden) in Australia in 2018. It contributed to a higher proportion of all fatal burden (8.1%) than non-fatal burden (2.3%) (AIHW 2021).

It was estimated that high blood pressure contributed 63% of hypertensive heart disease total burden, 42% of coronary heart disease burden, 39% of stroke burden, 37% of chronic kidney disease burden, and 31% of atrial fibrillation and flutter burden in 2018 (AIHW 2021).

Self-reported data on high blood pressure or hypertension

The 2022 National Health Survey asked respondents whether they have high blood pressure or hypertension and invited respondents over 18 to have their blood pressure measured.

High blood pressure or hypertension was self-reported by 14.9% of adults (aged 18 years and over) in 2022. This is similar to 2014–15 (14.6%) but higher than 2017–18 (13.6%).

Rates of self-reported high blood pressure or hypertension were similar among men (15.2%) and women (14.6%) in 2022 (ABS 2023c).

Measured data on high blood pressure

Measured high blood pressure can indicate that a person may have hypertension or that their hypertension is uncontrolled and that they may need follow up with a health professional to strengthen their treatment.

Based on measured data, 23.3% of adults had high blood pressure in 2022. This was higher among men (24.5%) than women (22.1%) (ABS 2023c).

Measured high blood pressure increased with increasing age from 11.4% of 18–44-year-olds, 29.5% of 45–64-year-olds, 38.9% of 65–74-year-olds to 42.9% of people aged 75 years and older (ABS 2023f).

After adjusting for the effects of age the rate of measured high blood pressure has remained similar over the last decade (ABS 2023f).

Self-reported high blood pressure considerably underestimates the true impact of high blood pressure in the population, as it often presents no symptoms and many people therefore remain unaware they have out-of-range levels. Of those adults who had measured high blood pressure, 74.5% did not report having hypertension or high blood pressure (ABS 2023c), similar to 2011–12 (71.9%) (ABS 2013b).

Controlled high blood pressure

People with high blood pressure (hypertension) are considered to have it under control if the measurements are in the normal range. This control can occur by following a healthy diet, keeping active, avoiding smoking and taking medication.

In December 2022, The Minister for Health and Aged Care, officially launched The National Hypertension Taskforce, which is a cross sector collaboration hosted by the Australian Cardiovascular Alliance, Hypertension Australia and including amongst others, the Heart Foundation and Stroke Foundation (Australian Cardiovascular Alliance n.d.).

The Taskforce aims to improve the proportion of people with controlled blood pressure in Australia to 70% by 2030 through increasing the prevention, detection and effective treatment of hypertension and bringing together primary health care and allied health professionals (National Hypertension Taskforce 2023).

In 2017–18, 33.7% of adults had measured high blood pressure and/or were taking blood pressure lowering medication. Of these 32.2% had their blood pressure controlled with medication (AIHW analysis of ABS 2019). After adjusting for age, these rates have not improved since 2011–12.

In 2017–18, 29.3% of men and 35.5% of women were controlling their blood pressure with medication. This was similar to 2014–15 (30.9% of men and 32.5% of women) and 2011–12 (30.8% of men and 33.0% of women) (AIHW analysis of ABS 2014, 2016, 2019).

New data for controlled high blood pressure in Australia will be available later in 2024.

Figure 2: Proportion of uncontrolled and controlled high blood pressure, 2011–12, 2014–15 and, 2017–18

Stacked bar chart shows the percent of adults with high blood pressure (both measured and people who are controlling their blood pressure with medication). For all years, of people with high blood pressure, 32% are controlling their blood pressure with medication.

Note: Chart displays crude rates.

Source: AIHW analysis of ABS data (ABS 2014, 2016, 2019)

Blood lipids (cholesterol and triglycerides)

Blood lipids are fats in the blood and include cholesterol and triglycerides (see glossary). Cholesterol is a fatty substance produced by the liver and carried by the blood to supply material for cell walls and hormones (see glossary). Triglycerides play an important role in metabolism as an energy source and in helping to transfer dietary fat throughout the body (see glossary).

When blood lipids are outside of the healthy range it is referred to as dyslipidaemia (see glossary). Dyslipidaemia can contribute to the development of atherosclerosis, a build-up of fatty deposits in the blood vessels. This build-up increases the risk of cardiovascular diseases.

Blood tests are used to determine levels of the commonly measured blood lipids. The standard lipid blood tests include measurements of total cholesterol, low-density lipoprotein cholesterol (LDL, or 'bad' cholesterol – see glossary), high-density lipoprotein cholesterol (HDL, or 'good' cholesterol – see glossary), as well as triglycerides.

Burden of high cholesterol

High cholesterol was the eighth leading risk factor and contributed to 2.7% of the ill health and premature deaths in Australia in 2018. It contributed 37% of coronary heart disease and 16% of stroke total burden (AIHW 2021). For more information, see Burden of disease.

Self-reported data on high cholesterol

In 2022, 10.7% of Australian adults reported having high cholesterol (ABS 2023b). In 2017–18, 7.8% of adults reported having high cholesterol. High cholesterol was reported by similar proportions of men (10.8%) and women (10.6%) in 2022 and increased with increasing age, from 1.1% for people aged 18–34 years to 29.0% among people 75 years and over (ABS 2023b).

Measured data on blood lipids (cholesterol and triglycerides)

In the 2011–12 AHS, blood lipid levels were measured via a blood test. A person had dyslipidaemia if they had one or more of the following:

  • total cholesterol greater than or equal to 5.5 mmol/L
  • LDL cholesterol greater than or equal to 3.5 mmol/L
  • HDL cholesterol less than 1.0 mmol/L in men or less than 1.3 mmol/L in women
  • triglycerides greater than or equal to 2mmol/L
  • or were taking lipid-modifying medication (ABS 2013a).

Based on these data, around 2 in 3 (63.2%) Australian adults had dyslipidaemia or blood lipids outside of the healthy range. This included 56.6% with uncontrolled dyslipidaemia and 6.6% with normal blood lipid levels who were taking lipid-modifying medication (AIHW analysis of ABS 2014; AIHW 2015). Men (63.7%) and women (62.8%) had similar levels of dyslipidaemia.

Self-reported data underestimate the true impact of dyslipidaemia in the population, as many people are unaware of their blood lipid levels. In 2011–12, the most recent year when measured data was collected, 1 in 3 (32.8%) Australians adults had abnormal or high total cholesterol levels according to their blood test results, similar for men and women (32.4% and 33.2%, respectively) (ABS 2013a).

Other biomedical risk factors

The Australian Burden of Disease Study also estimated the contribution of other biomedical risk factors to the total burden of disease in Australia. These are:

  • low birth weight and short gestation – contributed 0.7% of total disability-adjusted life years (DALYs; see glossary) in 2018
  • low bone mineral density – contributed 0.4% of total DALYs in 2018
  • iron deficiency – contributed 0.3% of total DALYs in 2018
  • impaired kidney function – contributed 1.9% of total DALYs in 2018 (AIHW 2021).

Multiple biomedical risk factors

Biomedical risk factors can interact and have a cumulative effect on disease risk. Having multiple risk factors can increase the risk of diseases developing, lead to earlier disease onset, increase severity and complicate treatment.

The development of one risk factor can lead to the occurrence of another, or they may have shared causes. For example, high blood pressure and dyslipidaemia are often related to poor diet and overweight.

Based on measured data from the 2011–12 AHS, an estimated 1 in 4 (25%) Australian adults had both high blood pressure and dyslipidaemia. This includes people with measured high blood pressure and dyslipidaemia, and those who take medication to control these conditions. This increased with increasing age, from 4.3% in people aged 18–34 to 65% in people aged 75 and over. Just over 7 in 10 (71%) adults had either high blood pressure, dyslipidaemia or both risk factors. This was highest in people aged 75 and over (96%) (AIHW analysis of ABS 2014; AIHW 2015).

Where do I go for more information?

For more information on biomedical risk factors, see:

For more on this topic, see Risk factors.