On Fri 04 Oct, Dr David J Plews responded to:
> > At 17:54 03/10/1996 +0100, Peter wrote:
> >
> > Can I get some ideas from the "coalface" of general practice?
> > I've a 72yr. old patient . . . her cholesterol came back as 9.6
> > and has not improved on dietary treatment. She has no history or
> > symptoms of IHD and her parents died of old age. One sister had
> > an MI at age 65+. I'm inclined to ignore it. What would you do?
> > I'd be most grateful for your opinions.
>
> Prof Ramsey in Sheffield has produced a really nice short paper on
> treating raised cholesterol.
>
> Prof Ramsey gave an evening lecturer recently in Rotherham. The
> "terrifying" consequences of the 4S and WOSCOPS (?) studies prove
> that primary and secondary prevention of IHD by targeting risk
> factors and in particularly raised cholesterol are that the NHS
> drug bill could rise by over 25% treating at this 3% risk level.
> Buy shares in drug companies selling 'statins now. You'll make a
> killing (sic), especially as you then wouldn't be able to prescribe
> their drugs:-)
The evidence from WOSCOPS suggests that treating raised cholesterol
with statins in males aged 40 - 65 living in the West of Scotland
reduces cardiac and overall mortality.
The Sheffield group have "extrapolated" the data. They suggest that
the cost effectiveness of treating raised cholesterol increases with
age and co-existing risk factors.
They have produced a chart as a "ready reckoner" and, from memory,
this patient would fall into the treatment group.
Having said that, I'm always unhappy about extrapolated data ;-(
Trims.
--
Dr Ian Trimble mailto:[log in to unmask]
Sherwood Health Centre
Elmswood Gardens Tel: +44 115 962 4516
Nottingham NG5 4AD Fax: +44 115 985 7899
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|