The National Institute of Health and Clinical Excellence has published new guidance for the month of May.
The former guideline (Quick Reference PDF) provides advice for risk management by lipid modification in patients at high risk of cardiovascular disease and those who have already had a cardiovascular event or have cardiovascular disease. This guideline has been reported in the general media (BBC) due to the prediction that an additional 1.5 million people could be prescribed a statin.
The update to the Diabetes guideline (Quick Reference PDF) covers:
- Lifestyle Management
- Appropriate use of self monitoring of blood glucose
- Blood pressure targets and management
- CVD Risk prediction
- Lipid targets and management
- Eye, Kidney and Nerve Damage
These guidelines are the first National Policy documents to contain secondary prevention cholesterol targets of 4mmol/L for total cholesterol and 2mmol/L for LDL. These targets also apply to patients with diabetes who are started on lipid lowering drugs. NICE also recommend auditing based on a total cholesterol of 5mmol/L in recognition of the fact that half of patients will not achieve these targets.
Simvastatin 40mg is the recommended first line therapy for all patients. There is no recommended target for primary prevention and moving high intensity statins is not recommended as routine.
Action: Clinicians should be aware of these recent guidelines and ensure that current practice is updated to reflect the latest recommendations.