title: Offering statins to a population attending health checks with a 10-year cardiovascular disease risk between 10% and 20.
abstract: BACKGROUND
  In 2014 the UK National Institute for Health and Care Excellence recommended reducing the threshold for offering statin therapy to patients from a 10-year modelled risk of cardiovascular disease (CVD) of 20% to 10%.
  
  
  OBJECTIVE
  To describe the response of patients in UK primary care with a CVD risk between 10% and 20% to an invitation to attend a consultation to discuss statins.
  
  
  METHODS
  Review of electronic medical records at one GP practice in the East of England.
  
  
  METHODS
  We invited all patients who had attended an NHS Health Check at the practice, had a QRisk(®) score between 10% and 20%, and were not prescribed statins to attend designated clinics in the practice to discuss starting statins. We reviewed the medical records to identify those who had attended the clinics and those who had chosen to start a statin.
  
  
  RESULTS
  Of 410 patients invited, 100 (24.4%) patients attended the designated clinics and 45 (11%) chose to start a statin. Those who chose to start a statin were older and with a higher QRisk(®) than those who did not. Among those who attended, individuals who started a statin had a higher QRisk(®) than those who did not and were more likely to be current or ex-smokers.
  
  
  CONCLUSIONS
  The proportion choosing to start a statin was substantially lower than previously estimated. Large population-based studies with long-term follow-up are needed to assess the impact on health and workload of this change in guidance.
authors.affiliation: The Primary Care Unit, Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, UK.|Firs House Surgery, Cambridge, UK.
authors.forename: J A
authors.identifier: http://orcid.org/0000-0002-8501-2531
authors.initials: JA
authors.lastname: Usher-Smith
authors.affiliation: Firs House Surgery, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Pritchard
authors.affiliation: Firs House Surgery, Cambridge, UK.
authors.forename: S
authors.initials: S
authors.lastname: Poole
authors.affiliation: The Primary Care Unit, Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Griffin
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000517:prevention & control*; D004739:England; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D018570:Risk Assessment
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors