Thousands More Could Be Prescribed Statins - NICE

Thousands more people could be prescribed statins to help lower cholesterol levels and reduce the risk of heart attacks and strokes, under draft guidance.

In an update to the existing guideline on lipid modification, the National Institute for Health and Care Excellence (NICE) is proposing that the threshold be halved for offering statins to people to prevent cardiovascular disease (CVD), the cause of 1 in 3 of all deaths in the UK.

Currently, only people with a 20 per cent or greater 10-year risk of developing CVD are offered statins. Draft guidance now recommends offering statins to people who have a 10 per cent or greater 10-year risk of developing CVD.

As many as 7 million people in the UK are currently believed to take statins, at an estimated annual cost of £285 million.

GPs should estimate the level of risk among their patients using the QRISK2 assessment tool and measurements including whether or not they smoke, their cholesterol levels, blood pressure, and body mass index. The calculator then provides a percentage risk of developing CVD in the next 10 years.

NICE had previously recommended the US Framingham risk tool before withdrawing advice about which risk assessment tool to use in February 2010. New evidence has suggested that QRISK2 is a more accurate CVD risk tool particularly among ethnic populations.

Patients with type 2 diabetes should, however, have their risk assessed using the UKPDS risk tool.

NICE recommends that GPs start statin treatment for the primary prevention of CVD with atorvastatin 20 mg. Patients with established CVD, type 1 diabetes or type 2 diabetes should be offered a higher strength 80mg dose of atorvastatin.


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