Lipid modification therapy

A summary of the NICE lipid modification guideline 2014 on A4Medicine.

CV risk assessment- Estimate CV risk using CV risk factors already known People > 40 yrs - risk assessment on ongoing basis Formal risk assessment if CV risk > 10 % or more Routinely record (a) ethnicity (b) BMI (c) family hx of premature CV dis in medical records Assess readiness to change lifestyle

Risk assessment calculators

https://qrisk.org/three/

https://www.escardio.org/Education/Practice-Tools/CVD-prevention-toolbox/SCORE-Risk-Charts

http://www.cvriskcalculator.com/

Risk calculators QRisk2 etc- Provide approximate value consider factors that may (a) predispose the person to premature CV dis (b) not be included in calculated risk score Risk score will underestimate risk in people with HIV treatment serious mental health problems medications which can cause dyslipidaemia ( antipsychotics , corticosteroids or immunosuppresants ) auto-immune disorders such( SLE & other systemic inflammatory disorders ) CV risk will be underestimated if already on anti-hypertensives and lipid modification therapy or recently stopped smoking BMI > 40 ↑↑ CVS risk People > 85 consider ^ risk of CV disease

When not to use - Type 1 diabetes - consider all adults forstatin therapy If estimated GFR < 60 and or albuminuria- already ↑↑ risk of CV disease Pre-existing CV diseases Known familial hypercholesterolaemia...