Offering statins to a population attending health checks with a 10-year cardiovascular disease risk between 10% and 20%

Abstract

Background In 2014 the UK National Institute for Health and Care Excellence recommended reducing the threshold for offering statin therapy to patients from a 10-year modelled risk of cardiovascular disease (CVD) of 20% to 10%. Aim To describe the response of patients in UK primary care with a CVD risk between 10% and 20% to an invitation to attend a consultation to discuss statins. Design and Setting Review of electronic medical records at one GP practice in the East of England. Method We invited all patients who had attended an NHS Health Check at the practice, had a QRisk score between 10% and 20%, and were not prescribed statins to attend designated clinics in the practice to discuss starting statins. We reviewed the medical records to identify those who had attended the clinics and those who had chosen to start a statin. Results Of 410 patients invited, 100 (24.4%) patients attended the designated clinics and 45 (11%) chose to start a statin. Those who chose to start a statin were older and with a higher QRisk than those who did not. Among those who attended, individuals who started a statin had a higher QRisk than those who did not and were more likely to be current or ex-smokers. Conclusions The proportion choosing to start a statin was substantially lower than previously estimated. Large population-based studies with long-term follow-up are needed to assess the impact on health and workload of this change in guidance.