BMJ 2000;320:1134-1140 ( 22 April )

Education and debate

What is the optimal age for starting lipid lowering treatment? A mathematical model

Silvia Ulrich, visiting research fellow ^a,  Aroon D Hingorani, British Heart Foundation Gerry Turner fellow ^a,  John Martin, professor ^b,  Patrick Vallance, professor ^a. 

^a Centre for Clinical Pharmacology and Therapeutics, University College, London WC1 6JJ, ^b Centre for Cardiovascular Biology and Medicine, University College London

Correspondence to: P Vallance patrick.vallance@ucl.ac.uk

The first 150 words of the full text of this article appear below.

Coronary heart disease is the major cause of morbidity and mortality in industrialised countries. The Framingham cohort study has identified the quantitative impact of different risk factors and their interactions,^1-3 and large intervention studies have confirmed that drug treatment to reduce risk factors decreases progression to heart attack and stroke. ^{4 5} However, with this increased understanding have come additional problems. The treatments to reduce cholesterol concentrations or blood pressure are often expensive, and the population that might benefit is vast. Indeed if every individual who might benefit was treated with a statin or fibrate, a large portion of the total drugs budget would be consumed.⁶ Thus some form of rationing is inevitable, and various recommendations have emerged in an attempt to contain cost while targeting treatment at those who stand to gain the most. Current UK policy recommends treatment should be offered to anyone with an absolute annual risk of 3% . . . [Full text of this article]

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Optimal age for starting lipid lowering treatment

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Rapid Responses:

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Lipid lowering treatment for primary prevention

Pitt O Lim
bmj.com, 22 Apr 2000 [Full text]

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