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NICE issues major guideline on cardiovascular disease

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Practice nurses and GPs should seek to systematically identify all patients aged between 40 and 75 who may be at risk from cardiovascular disease, according to latest guidelines.

NICE said that risk should be based on CVD risk factors already recorded in primary care electronic medical records and assessed using a modified Framingham 10-year risk equation.

Statins are recommended for the primary prevention of CVD for adults who have a 20% or greater 10-year risk, once other ways of managing risk factors have been tried. Treatment should be initiated with the generic drug simvastatin 40mg.

For secondary prevention, statins are recommended for all adults with clinical evidence of CVD.

NICE Deputy Chief Executive Dr Gillian Leng said: ‘This guideline will provide much needed clarity for healthcare professionals, many of whom report uncertainty in how to manage blood lipids in patients both with and without pre-existing cardiovascular disease.’

But Professor Peter Weissberg, medical director of the British Heart Foundation, said: ‘The BHF is disappointed that NICE ducked the issue of providing guidance on target levels of cholesterol for people who don’t yet have heart disease, but are at high risk.

‘It has focused its advice entirely on generic statins which may not achieve meaningful reductions in cholesterol levels,’ he said.

For full details and responses to this story read next week’s NT.

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