K Rowland Yeo1, W W Yeo. 1. Clinical Pharmacology and Therapeutics, Division of Clinical Sciences, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK. k.r.yeo@sheffield.ac.uk
Abstract
OBJECTIVE: To examine the impact for the UK population of providing statin treatment for diabetic patients for the primary prevention of coronary heart disease at a coronary event risk lower than currently recommended by the National Service Framework (NSF) for coronary heart disease. DESIGN: Cross sectional survey. SETTING: England 1998. PARTICIPANTS: Nationally representative sample of 6879 subjects aged 35-74 years living in private households. MAIN OUTCOME MEASURES: The proportion of the UK population recommended for statin treatment according to the NSF for coronary heart disease, and the proportion of the population with diabetes at a coronary disease event risk of > or = 15% over 10 years. RESULTS: Of the 6879 subjects with total cholesterol measurements, 218 (3.2%) had diabetes mellitus. In this nationally representative sample, 6.3% of the subjects (95% confidence interval (CI), 5.7% to 6.9%) were candidates for statin treatment for the secondary prevention of coronary heart disease, including 0.7% (95% CI 0.5% to 0.9%) with diabetes. A further 2.4% (95% CI 2.0% to 2.8%), including 0.4% (0.2% to 0.6%) with diabetes, were identified as candidates for primary prevention of coronary heart disease according to the NSF for coronary heart disease. Lowering the primary prevention threshold for statin treatment to a coronary event risk of > or = 15% over 10 years in diabetic patients identified an additional 0.5% of the population. CONCLUSIONS: Extending statin treatment to diabetic patients at a coronary heart disease risk of > or = 15% over 10 years would have a relatively small numerical impact in the UK population. Thus patients with diabetes mellitus should, as a minimum, be targeted for statin treatment at this level of risk.
OBJECTIVE: To examine the impact for the UK population of providing statin treatment for diabeticpatients for the primary prevention of coronary heart disease at a coronary event risk lower than currently recommended by the National Service Framework (NSF) for coronary heart disease. DESIGN: Cross sectional survey. SETTING: England 1998. PARTICIPANTS: Nationally representative sample of 6879 subjects aged 35-74 years living in private households. MAIN OUTCOME MEASURES: The proportion of the UK population recommended for statin treatment according to the NSF for coronary heart disease, and the proportion of the population with diabetes at a coronary disease event risk of > or = 15% over 10 years. RESULTS: Of the 6879 subjects with total cholesterol measurements, 218 (3.2%) had diabetes mellitus. In this nationally representative sample, 6.3% of the subjects (95% confidence interval (CI), 5.7% to 6.9%) were candidates for statin treatment for the secondary prevention of coronary heart disease, including 0.7% (95% CI 0.5% to 0.9%) with diabetes. A further 2.4% (95% CI 2.0% to 2.8%), including 0.4% (0.2% to 0.6%) with diabetes, were identified as candidates for primary prevention of coronary heart disease according to the NSF for coronary heart disease. Lowering the primary prevention threshold for statin treatment to a coronary event risk of > or = 15% over 10 years in diabeticpatients identified an additional 0.5% of the population. CONCLUSIONS: Extending statin treatment to diabeticpatients at a coronary heart disease risk of > or = 15% over 10 years would have a relatively small numerical impact in the UK population. Thus patients with diabetes mellitus should, as a minimum, be targeted for statin treatment at this level of risk.
Authors: J R Downs; M Clearfield; S Weis; E Whitney; D R Shapiro; P A Beere; A Langendorfer; E A Stein; W Kruyer; A M Gotto Journal: JAMA Date: 1998-05-27 Impact factor: 56.272
Authors: J Shepherd; S M Cobbe; I Ford; C G Isles; A R Lorimer; P W MacFarlane; J H McKillop; C J Packard Journal: N Engl J Med Date: 1995-11-16 Impact factor: 91.245