National service framework for coronary heart disease

doi:10.1136/bmj.321.7261.634

BMJ 2000;321:634 ( 9 September )

Letters

National service framework for coronary heart disease

Ambiguities need to be clarified

Target of lowering cholesterol by 30% needs to be justified

Many operators and facilities will not meet standards set out in framework

Ambiguities need to be clarified

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

EDITOR $---$ One of the priorities in the national service framework for coronary heart disease summarised by Mayor¹ was "improveduse of effective medicines after heart attack $---$ especially aspirin, $beta$ blockers, and statins $---$ so that 80-90% of people discharged fromhospital after a heart attack will be prescribed these drugs."This is the recommendation in the executive summary, which takenat face value implies that all three drugs should be prescribedbefore a patient leaves hospital. In contrast, the recommendationin the main document is that aspirin and $beta$ blocker treatment shouldbe started in hospital and statin treatment left for "continuingcare."

Statin treatment was not started at the time of infarction in any of the large secondary prevention studies. The shortesttimes from infarction to inclusion were six months in the Scandinaviansimvastatin survival study (4S),² and three months in the cholesteroland recurrent events (CARE) study³ and the long . . . [Full text of this article]

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This article has been cited by other articles:

Quinn, T. (2009). A decade of improvement for cardiac patients in England. Journal of Research in Nursing 14: 199-202
Boyle, R. (2000). DoH explains thinking behind national service framework for coronary heart disease. BMJ 321: 1083-1083 [Full text]