Implications of lower risk thresholds for statin treatment in primary prevention: Analysis of CPRD and simulation modelling of annual cholesterol monitoring

Emily McFadden, Richard Stevens, Paul Glasziou, Rafael Perera

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Objective: To estimate numbers affected by a recent change in UK guidelines for statin use in primary prevention of cardiovascular disease. Method: We modelled cholesterol ratio over time using a sample of 45,151 men (≥ 40 years) and 36,168 women (≥ 55 years) in 2006, without statin treatment or previous cardiovascular disease, from the Clinical Practice Research Datalink. Using simulation methods, we estimated numbers indicated for new statin treatment, if cholesterol was measured annually and used in the QRISK2 CVD risk calculator, using the previous 20% and newly recommended 10% thresholds. Results: We estimate that 58% of men and 55% of women would be indicated for treatment by five years and 71% of men and 73% of women by ten years using the 20% threshold. Using the proposed threshold of 10%, 84% of men and 90% of women would be indicated for treatment by 5. years and 92% of men and 98% of women by ten years. Conclusion: The proposed change of risk threshold from 20% to 10% would result in the substantial majority of those recommended for cholesterol testing being indicated for statin treatment. Implications depend on the value of statins in those at low to medium risk, and whether there are harms.

Original languageEnglish
Pages (from-to)14-16
Number of pages3
JournalPreventive Medicine
Volume70
DOIs
Publication statusPublished - 1 Jan 2015

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Primary Prevention
Cholesterol
Cardiovascular Diseases
Therapeutics
Guidelines
Research

Cite this

@article{2f79879f35c24b3e826043049f7abd4c,
title = "Implications of lower risk thresholds for statin treatment in primary prevention: Analysis of CPRD and simulation modelling of annual cholesterol monitoring",
abstract = "Objective: To estimate numbers affected by a recent change in UK guidelines for statin use in primary prevention of cardiovascular disease. Method: We modelled cholesterol ratio over time using a sample of 45,151 men (≥ 40 years) and 36,168 women (≥ 55 years) in 2006, without statin treatment or previous cardiovascular disease, from the Clinical Practice Research Datalink. Using simulation methods, we estimated numbers indicated for new statin treatment, if cholesterol was measured annually and used in the QRISK2 CVD risk calculator, using the previous 20{\%} and newly recommended 10{\%} thresholds. Results: We estimate that 58{\%} of men and 55{\%} of women would be indicated for treatment by five years and 71{\%} of men and 73{\%} of women by ten years using the 20{\%} threshold. Using the proposed threshold of 10{\%}, 84{\%} of men and 90{\%} of women would be indicated for treatment by 5. years and 92{\%} of men and 98{\%} of women by ten years. Conclusion: The proposed change of risk threshold from 20{\%} to 10{\%} would result in the substantial majority of those recommended for cholesterol testing being indicated for statin treatment. Implications depend on the value of statins in those at low to medium risk, and whether there are harms.",
author = "Emily McFadden and Richard Stevens and Paul Glasziou and Rafael Perera",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.ypmed.2014.11.004",
language = "English",
volume = "70",
pages = "14--16",
journal = "Preventive Medicine",
issn = "0091-7435",
publisher = "Elsevier",

}

Implications of lower risk thresholds for statin treatment in primary prevention : Analysis of CPRD and simulation modelling of annual cholesterol monitoring. / McFadden, Emily; Stevens, Richard; Glasziou, Paul; Perera, Rafael.

In: Preventive Medicine, Vol. 70, 01.01.2015, p. 14-16.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Implications of lower risk thresholds for statin treatment in primary prevention

T2 - Analysis of CPRD and simulation modelling of annual cholesterol monitoring

AU - McFadden, Emily

AU - Stevens, Richard

AU - Glasziou, Paul

AU - Perera, Rafael

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective: To estimate numbers affected by a recent change in UK guidelines for statin use in primary prevention of cardiovascular disease. Method: We modelled cholesterol ratio over time using a sample of 45,151 men (≥ 40 years) and 36,168 women (≥ 55 years) in 2006, without statin treatment or previous cardiovascular disease, from the Clinical Practice Research Datalink. Using simulation methods, we estimated numbers indicated for new statin treatment, if cholesterol was measured annually and used in the QRISK2 CVD risk calculator, using the previous 20% and newly recommended 10% thresholds. Results: We estimate that 58% of men and 55% of women would be indicated for treatment by five years and 71% of men and 73% of women by ten years using the 20% threshold. Using the proposed threshold of 10%, 84% of men and 90% of women would be indicated for treatment by 5. years and 92% of men and 98% of women by ten years. Conclusion: The proposed change of risk threshold from 20% to 10% would result in the substantial majority of those recommended for cholesterol testing being indicated for statin treatment. Implications depend on the value of statins in those at low to medium risk, and whether there are harms.

AB - Objective: To estimate numbers affected by a recent change in UK guidelines for statin use in primary prevention of cardiovascular disease. Method: We modelled cholesterol ratio over time using a sample of 45,151 men (≥ 40 years) and 36,168 women (≥ 55 years) in 2006, without statin treatment or previous cardiovascular disease, from the Clinical Practice Research Datalink. Using simulation methods, we estimated numbers indicated for new statin treatment, if cholesterol was measured annually and used in the QRISK2 CVD risk calculator, using the previous 20% and newly recommended 10% thresholds. Results: We estimate that 58% of men and 55% of women would be indicated for treatment by five years and 71% of men and 73% of women by ten years using the 20% threshold. Using the proposed threshold of 10%, 84% of men and 90% of women would be indicated for treatment by 5. years and 92% of men and 98% of women by ten years. Conclusion: The proposed change of risk threshold from 20% to 10% would result in the substantial majority of those recommended for cholesterol testing being indicated for statin treatment. Implications depend on the value of statins in those at low to medium risk, and whether there are harms.

UR - http://www.scopus.com/inward/record.url?scp=84911409341&partnerID=8YFLogxK

U2 - 10.1016/j.ypmed.2014.11.004

DO - 10.1016/j.ypmed.2014.11.004

M3 - Article

VL - 70

SP - 14

EP - 16

JO - Preventive Medicine

JF - Preventive Medicine

SN - 0091-7435

ER -