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NICE statins guide takes UK close to universal treatment

NICE guidance on use of statins is the most ambitious in the Western world and would take the UK close to universal treatment, a new study reveals.

The institute's new appraisal ­ set to form the basis of cardiovascular screening from next year ­ will treat more than three-quarters of all middle-aged men. And the research, which prospectively examined cardiovascular risk in 1,653 men aged 49-65 in Wales, found even treating every single one was more efficient than many existing interventions.

Study leader Professor Paul Durrington, professor of medicine at the University of Manchester, said: 'New Joint British Societies recommendations [equivalent to NICE] had the greatest population impact ­ but targeted three-quarters of this population.

'Even providing statins to the whole male population, the number needed to treat is still better than most other treatments, including for hypertension,' he said.

The suggestion that all men over a certain age could get statins caused nervousness.

Dr Terry McCormack, chair of the Primary Care Cardiovascular Society and a GP in Whitby, East Yorkshire, said: 'It's the "it should be in the water" theory. I don't think we've got to the point where we put the whole population on a treatment.'

Dr Mike Parks, chair of Kent LMC, said: 'It's going to put enormous strain on the NHS, particularly primary care ­ where it has to be managed.'

But Dr John Ashcroft, CHD lead for Erewash PCT and a GP in Ilkeston, Derbyshire, said: 'The workload is huge, but the potential for gain is even bigger. Men should probably all be on simvastatin by the time they're over 70 and aspirin as well over 75.'

The study, published online by Heart, found under NICE statins would be prescribed to 77 per cent of men aged 45-65, with 22 patients treated for 10 years for every cardiovascular event prevented (see box, left).

Treating the entire population would raise the number needed to treat to 26 but prevent a greater number of events.

dcressey@cmpi.biz

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