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Increased statin use to lower cholesterol: consultation

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Draft NICE guidance now recommends offering statins to people who have a 10 per cent or a 10-year risk of developing cardiovascular disease (CVD).

This would represent an increase in the numbers taking statins as only people with a 20 per cent or more than a10-year risk of developing CVD are offered statins under current guidelines.

GPs and practice nurses should estimate the level of risk among their patients using the QRISK2 assessment tool and parameters such as 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 ten years.

‘People should be encouraged to address any lifestyle factors such as smoking, drinking too much or eating unhealthily. We also recommend that statins are now offered to many more people - the effectiveness of these medicines is now well proven and their cost has fallen,' said Professor Mark Baker, director of the Centre for Clinical Practice at NICE.

‘We now want to hear views on this draft guidance which recommends that people with a 10 per cent risk of developing CVD within 10 years are offered statins. Clinicians will need to make a judgment about the risks to people who have a less than 10 per cent risk of developing CVD and advise them appropriately,' he added.

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 have their risk assessed using the UKPDS risk tool.

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

Registered stakeholders, such as professional and government organisations, patient and carer groups, and companies, have until the 26 March 2014 to comment on the draft guidance.

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