The guidelines recommend nurses and GPs should check the medical records of patients aged 40–75 to identify those likely to have a cardiovascular event in the next 10 years.
High-risk patients should be offered a formal risk assessment and advice on managing modifiable risk factors such as smoking, hypertension and raised cholesterol. Adults considered to have a 20% or greater 10-year risk of developing CVD – based on Framingham risk scores – should be offered drug therapy with generic simvastatin 40mg.
The institute said CVD ‘systematic identification’ of high-risk patients would prevent 15,000 cardiovascular events in England and Wales every year.
Guideline development group member Maureen Hogg, coronary heart disease lead nurse for Lanarkshire NHS Trust, said: ‘Much of this work is already carried out by nurses but the guideline provides a systematic rather than opportunistic approach to the care and treatment of people at increased risk of CVD.’
Jan Proctor-King, cardiovascular tutor at the primary care training centre in Bradford, and Primary Care Cardiovascular Society board member, said: ‘Prevention of CVD is a fundamental role of primary care nursing and I urge practice nurses to participate in any opportunities that arise in cardiovascular assessment.’
The guidelines come a few months after the government announced plans for a vascular screening programme for 40 to 74-year-olds, due to start next year (NT News, 8 April, p4).
Californian research published last week revealed nearly half of patients with history of CVD have poor knowledge about their symptoms and risk levels.
In a survey of 3,522 patients with history of CVD, 44% were judged to have low knowledge levels and 43% inappropriately assessed their risk as less than or the same as others their age.
Archives of Internal Medicine (2008) 168: 1049–1054