Letters

Use of statins

Adequacy of SMAC's statement should be judged by clinicians, not health economists

See editorial by Muldoon

Editor–Freemantle et al's editorial argues that the statement on the use of statins in coronary heart disease prepared by the Standing Medical Advisory Committee and issued recently by the NHS Executive is "simply inadequate."^{1 2} The adequacy or otherwise of advice depends on the context in which it was issued and whether it is appropriate for the purpose.

The context was the dramatic increase in the prescribing of statins since the publication of two landmark randomised controlled trials (the 4S (Scandinavian simvastatin survival study)³ and WOSCOPS (the west of Scotland coronary prevention study)⁴). Guidance issued by the European Society of Cardiology advised treating those of the population with a risk of coronary heart disease of 2% a year,⁵ and others have advocated treating those with a risk of 1.5%. The annual cost to the . . . [Full text of this article]

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This article has been cited by other articles:

• Fahey, T. (1998). Assessing heart disease risk in primary care. BMJ 317: 1093-1094 [Full text]  
• Ramsay, L E, Wallis, E J, Haq, I U, Williamson, R, Yeo, W W, Jackson, P R, McLeod, A. J, Armitage, M. (1998). Use of statins. BMJ 317: 473a-473 [Full text]  
• Muldoon, M. F, Criqui, M. H (1997). The emerging role of statins in the prevention of coronary heart disease. BMJ 315: 1554-1555 [Full text]