The 1.4 million Australians at risk of heart attacks and strokes are failing to take steps to avoid the diseases.
The vast majority of the 45-74-year-olds considered highly vulnerable to cardiovascular disease are missing out on vital risk assessments and medications to address high blood pressure and cholesterol, a study published in the Medical Journal of Australia has found.
That's despite heart disease being a leading cause of death in Australia.
A dearth of understanding around the potentially life-saving benefits of preventative treatments could be to blame for people being reluctant to seek them, authors say.
The analysis, of more than 9500 responses in the 2011-12 National Health Measures Survey, found that those who smoked and had high blood pressure, high cholesterol, diabetes and lower kidney function were among the most vulnerable.
But at-risk people could approximately halve their chances of enduring a heart attack or stroke if they got appropriate therapies.
"There is this huge potential for prevention that is being missed," lead author Emily Banks from Australian National University said told AAP.
"The first thing is for people to understand just how effective these medicines can be.
"If you stop smoking, start taking these medications, get your cholesterol and blood pressure under control, you can substantially reduce your risk."
While those at the highest risk were failing to address the issue, people who did not believe they were susceptible also needed to seek assessment.
"Often for people, the first sign that they're at risk is actually having a heart attack or stroke," Professor Banks said.
"We certainly find that if people have a heart attack or stroke, their first response is often 'why me?'.
"People don't have a sense that they might be at risk."
The Heart Foundation said the figures should serve as a wake-up call, with governments - not just individuals - having a role to play in improving the statistics around access to treatment.
"It's time to do more to reduce death and suffering ... including encouraging community awareness and providing greater government support to general practice for these life-saving heart checks," the organisation's chief medical adviser Professor Garry Jennings said.
