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Sheffield table is useful ...
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EDITOR
Two letters last December on the use of statins, by
Betteridge et al (p 1619) and Reynolds et al (p 1620), criticised the
Sheffield table.1 The rate of coronary heart disease
events targeted (3% per year) is not "arbitrarily high," as
Reynolds et al say, but was proposed after consideration of the number needed to treat, cost effectiveness, proportion of adults needing treatment, and total cost of treatment at different thresholds of risk
of coronary heart disease.2 The European task force's guidelines3 which suggested the 2% per year threshold for
coronary heart disease preferred by the letters' authors predated the
statin trials.
We do not accept that high risk people over age 65 should be denied
treatment,1 and treating those below age 65 with a relative risk of coronary heart disease of
41 seems
unwise. A 35 year old woman with a total cholesterol concentration of 7.0 mmol/l, systolic blood pressure of 160 mm Hg,
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