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Lifetime risk is the way to go

I totally agree with using lifetime risk to assess the need for treatment. I always used to follow JBS2 guidelines treating to cholesterol targets of 4 and 2 (after deciding the need for treatment).

If the patient had what looked like high risk factors but did not reach treatment thresholds, I would put their age in the calculator as 65 (even if they were younger) to assess their 10-year risk to age 75 and treat accordingly.

I could never see the point of starting treatment after patients’ arteries were already furred up.

Sadly, now for financial reasons we are using the NICE guidelines, but I do not think we are doing our patients any favours by doing so.

From Dr Lois Benjamin,
Enfield, Middlesex