Far more people are at risk of cardiovascular disease than the guidelines currently show, the National Institute for Health and Care Excellence (NICE) believes.
Draft guidance suggests that the threshold for starting preventative treatment for heart disease, stroke or peripheral arterial disease should be halved from a 20% risk to a 10% risk.
People can be at risk from CVD because of factors they cannot change including their age, sex, ethnicity, and family history.
The draft guidance recommends that risk factors which can be addressed should be managed. These include stopping smoking, reducing alcohol consumption, taking exercise and eating a healthy diet.
Once these factors have been addressed, the draft guidance says high intensity statin therapy should be offered.
NICE recommends that people are assessed (using the QRISK2 calculator) for their risk of developing cardiovascular disease using measurements including whether or not they smoke, their cholesterol levels, blood pressure, and body mass index. The calculator then provides a percentage risk of developing CVD in the next 10 years. The guidance also highlights that standard CVD risk scores will underestimate risk in people receiving certain treatments or who have an underlying condition, including: - People treated for HIV. - People with serious mental health problems. - People taking medicines that can cause dyslipidaemia such as antipsychotic medication, corticosteroids, or immunosuppressant drugs. - People with stage 1 or 2 chronic kidney disease. - People with autoimmune disorders such as systemic lupus erythematosus (SLE), rheumatoid arthritis and other systemic inflammatory disorders.
Professor Mark Baker, director of the centre for clinical practice at NICE said: "We recommend that statins are now offered to many more people – the effectiveness of these medicines is now well proven and their cost has fallen.
“As well as taking statins, people with raised cholesterol levels and high blood pressure should reduce the amount of foods containing saturated fat they eat (meat, cheese and milk), they should exercise more and control their blood glucose levels by reducing their intake of sugar and by losing weight. They should also stop smoking.” As many as seven million people in the UK are currently believed to take statins, at an estimated annual cost of £450 million.
Cardiovascular disease (CVD) conditions cause a third of all deaths in the UK.