Thursday, 27 December 2012

NICE guidelines on Lipid Management & Statins being updated

reposted from:
crabsallover highlightskey pointscomments / links.

Following on from the CTT 2012 report, NICE are investigating new guidelines for use of statins for people with a <=10% risk of heart attack or stroke in next 10 years.

NICE guidelines on lipid management and use of Statins are being updated. See the scope and 2nd meeting (October 2012) minutes.

The risk assessment stage of the NHS Health Check (formerly known as the Vascular Check Programme) uses a risk engine for people aged 40–74 years to calculate their 10-year risk of CVD. Blood lipids, including cholesterol, are a modifiable risk factor for CVD. The risk of CVD is directly related to blood cholesterol levels and it is estimated that more than 50% of CVD in developed countries is a result of blood cholesterol levels higher than 3.8 mmol/litre. Blood cholesterol and other lipid components can be modified by drugs, physical activity and dietary changes; a multifactorial approach is likely to yield most benefit. (pg 2 of scope)

Key clinical issues that will be covered a) The most appropriate risk tool system to estimate a person’s absolute risk of developing CVD for: people without diabetes – for example, age alone, QRISK and Framingham risk assessment tools (10-year or lifetime risk)

Lipid modification strategy: for example, fixed dose or treating to a target lipid level.

c) Pharmacological interventions
(1) to reduce the risk of developing CVD (primary prevention) and (2) for secondary prevention in people with established CVD:
First-line treatment: statins.
Second-line treatment (alone or in combination with statins):
fibrates, anion-exchange resins, nicotinic acid group, omega-3 fatty acids.

5.1.1 NICE guidance to be updated
This guideline will update and replace the following NICE guidance:
Lipid modification. NICE clinical guideline 67 (2008).
Statins for the prevention of cardiovascular events. NICE technology appraisal guidance 94 (2006).

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