Society’s OTC statin guidelines criticised
Guidelines for over-the-counter statin treatment produced by the Royal Pharmaceutical Society could lead to under-treatment of high risk individuals and unnecessary treatment for people at low risk of heart disease, according to the authors of a letter published in the BMJ this week (2006;333:704).
The authors say that by using the Society’s criteria, rather than
Framingham estimates of coronary heart disease risk, up to 18 per cent
of people at low risk and 39 per cent of those at high risk could be
misclassified as being at moderate risk of coronary heart disease, making
them eligible for over-the-counter statin treatment. “If Framingham-derived
cardiovascular risk, including blood pressure and cholesterol, cannot
be checked in the pharmacy, we recommend that people are referred to
their general practitioner for an accurate risk assessment,” they
conclude.
Sadia Khan, lead for self care at the Society, said that the letter raises
various concerns over practice guidance on OTC simvastatin and that the
Society would be responding to the BMJ in due course.
OTC statin Commenting
on a discussion of the appropriateness of adopting OTC statins in the
US (Circulation 2006;114:1310), Australian doctors
say that the
agents, if available over the counter, will be used by many people for whom
simple lifestyle measures would be sufficient. |
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