New guidelines set lower cholesterol targets
New clinical guidelines predicted to reduce the number of people dying
each year from cardiovascular disease have been published in a supplement
to the December issue of Heart.
The guidelines
replace the Joint British Societies Guidelines on Coronary Prevention
in Clinical Practice (JBS 1) which were published in 1998.
The new guidelines widen the criteria for prevention of heart disease
and stroke in primary care and for the first time target patients with
cardiovascular disease (CVD). The previous guidelines applied only to
those patients with coronary heart disease (CHD).
They also, for the first time, recommend that all at-risk patients, as
well as those with established disease, have access to the full range
of treatment — including medication.
Although the blood pressure targets in the new guidelines (JBS 2) are
the same as JBS 1, they recommend a lower target level for cholesterol.
The new guidelines recommend a total cholesterol target of 4.0mmol/L (compared
with 5.0mmol/L under JBS 1) and a target for low-density lipoprotein cholesterol
of 2.0 mmol/L (compared with less than 3mmol/L under JBS 1), or a 25 per
cent reduction in total cholesterol and a 30 per cent reduction in LDL
cholesterol, whichever achieves the lowest absolute value.
The guidelines also recommend that everybody who has been assessed as
having a CVD risk of more than 20 per cent over the next 10 years should
be receiving appropriate drug treatment.
Commenting on the guidelines, chairman of the Primary Care Cardiovascular
Society, GP Terry McCormack, said:“If the targets are followed,
JBS 2 will lead to more lives being saved and a considerable reduction
in incapacitating CV events.”
The guidelines, from the British Cardiac Society, the British Hypertension
Society, Diabetes UK, Heart UK, the Primary Care Cardiovascular Society
and the Stroke Association, recommend CVD screening for:
All adults aged 40 years and older, with no history
of heart attack, stroke, or diabetes, and not already being treated
for high blood pressure or cholesterol
All adults under 40 years with a family history of developing hardened
and narrowed arteries earlier than expected (under 65 years for women
and under 55 years for men). |
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