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Avoiding traps for the unwary in NHS leases

Hundreds of thousands of patients in the UK could be missing out on treatment with statins because of inaccurate cholesterol testing, a major new analysis concludes.

Some testing procedures could be out by as much as 30 per cent, according to the study, part of the UK National External Quality Assessment Scheme.

Heart UK, which co-ordinated the study through its medical and scientific committee, said older tests in particular were 'all over the place'.

Researchers sent blood samples to laboratories around the UK for cholesterol testing and compared the values with those obtained from a reference laboratory in Glasgow.

Some tests underestimated total cholesterol by up to 20 per cent in samples high in triglycerides. High triglyceride levels also skewed results for HDL cholesterol, with some tests overestimating levels by 30 per cent.

The researchers, who presented the results at this week's annual Heart UK scientific meeting in Glamorgan, concluded: 'Lipid results obtained by UK laboratories may adversely influence the assessment and treatment of patients by Framingham-based risk scores. Some patients in general practice may be denied access to treatment.'

Dr Tony Wierzbicki, secretary of the Heart UK medical and scientific committee, said: 'This could affect up to 10 per cent of patients. It's not necessarily a small problem. The tests vary between manufacturers but it affects all of them to a certain extent. Very old tests are going to be cheaper but they will be all over the place.'

Dr Jim Kennedy, RCGP prescribing spokesperson, called for national standards to be introduced. 'The issue that triglycerides affect HDL and cholesterol levels to the extent they do is important information for GPs.'

Dr Kennedy said serious problems could occur when a patient moved to a different area. 'If there is a big difference in their cholesterol level patients will start to lose faith in the whole process,' he added.

How to ensure your patients don't lose out

·Be aware that total cholesterol and HDL cholesterol readings may be inaccurate if patients have high triglyceride levels

·If triglyceride levels are high make sure patient had fasted and

if necessary repeat test

·If triglyceride levels remain high, contact lab for information on the test it uses and the likelihood of inaccuracies Source: Heart UK

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