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Annual cholesterol tests ‘not needed'

Annual checks for patients under treatment for high cholesterol should be scrapped, a new study claims.

Instead, patients adhering to treatment could be satisfactorily tested every three to five years, University of Oxford researchers conclude.

41190102They found a short-term variability in cholesterol levels of 7%, making it almost impossible to detect a true small increase – and prompting their conclusion that there is too much background ‘noise' to make annual tests worthwhile.

The analysis of serial cholesterol measurements in 9,014 people, taking part in a long-term randomised controlled trial of pravastatin, showed monitoring was likely to detect more false positives than true results for those whose levels were 0.5mmol/l or more under target.

The study was published in the Annals of Internal Medicine.

Study leader Professor Paul Glasziou, a practising GP and professor of evidence-based medicine at the University of Oxford, said: ‘Much of current testing will detect only false-positive results – changes related to short-term biological variation or analytical error.

‘I think this is pretty clear guidance that monitoring every few years should be sufficient. In between we should be seeing the patient and asking if they're taking their appropriate treatments or not.'

He said doubts remained on how frequently to test cholesterol in the period straight after starting statin therapy because of variations in people's resp-onses to pravastatin in the trial.

Dr Rubin Minhas, a GP in Gillingham, Kent, and cardiology lead for Medway PCT, said the findings had major implications.

He said cholesterol readings fluctuated so much from day to day in the same individual that GPs should accept a single reading within 0.5mmol/l of a target when deciding whether to increase the statin dose.

But Professor Ian Young, professor of medicine at Queen's University Belfast and spokes-person for the Association for Clinical Biochemistry, criticised the researchers' conclusion. He said: ‘Yearly checks allow a check on adherence – and that is vital.'

Statins Key findings

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