# Cholesterol, Not Just Cardiovascular Risk, Is Important in Deciding Who Should Receive Statins



## Northerner (Jan 13, 2016)

*Aims* Guidelines for primary prevention of cardiovascular disease (CVD) with statins, including the most recent, fail to make the best use of the evidence from clinical trials by concentrating on absolute CVD risk as a statin indication and not also considering that a major determinant of therapeutic benefit is the magnitude of the low-density lipoprotein (LDL) (or non-HDL) cholesterol reduction achieved. This decrease is proportional to the pretreatment concentration. We set out to apply this knowledge to the calculation of the number needed to treat to prevent one event (NNT) and to assess critically how current guidelines performed at different degrees of CVD risk across a range of LDL (or non-HDL) cholesterol concentrations.

*Methods and results* Number needed to treat to prevent one event revealed exclusion from the treatment of some people with higher cholesterol levels, who may benefit more than others needlessly exposed to statins with no realistic prospect of benefit. Furthermore, abandonment of cholesterol therapeutic goals disadvantaged people with higher levels.

*Conclusion* These problems can be overcome by basing the decision to treat on the NNT calculated both from absolute CVD risk and also on the LDL (or non-HDL) cholesterol reduction achievable with statin treatment. This need not adds an additional layer of complexity for the clinician, because computer programmes already used to estimate CVD risk could be easily amended, thus permitting more effective deployment of statins in the population.

http://www.medscape.com/viewarticle/855252


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## trophywench (Jan 13, 2016)

I want to read that but it's asking me to log on.

I think there's something wrong with the puter (or what's loaded on it rather than the machine) actually since on the MSN UK news homepage I use there is very little loading up and only the main news photos, none of the thumbnails and none of the sub-sections like eg Financial News or Lifestyle, just a blank page under the top 5 or so inches, and I have tried to access maps - Google, Mappy, the RAC and viamichelin - and the maps don't show.  Google maps says I need JavaScript and a link to download that which I clicked on - but that says I either need Chrome or Firefox, whereas I still use IE as I always have and its always been fine.

I'm also still on Windows 7 - haven't been tempted by 10 because the familiar things are different, more like a smartphone (which I have difficulty finding my way round anyway) and the Roche software only works on 7.

Help!!


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## grovesy (Jan 13, 2016)

I think it is Medscape as it asks me to log in can never read the articles.


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## Northerner (Jan 13, 2016)

grovesy said:


> I think it is Medscape as it asks me to log in can never read the articles.


Worth registering, it's free and they don't bombard you with spam or anything


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## grovesy (Jan 13, 2016)

Oh thanks I thought you had to belong to a an institution.


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