Guidelines from the British Hypertension Society: Authors' reply

doi:10.1136/bmj.329.7465.570-b

BMJ 2004;329:570-571 (4 September), doi:10.1136/bmj.329.7465.570-b

Letter

Guidelines from the British Hypertension Society

Authors' reply

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

EDITOR—The optimal lipid targets are a total cholesterolconcentration of < 4.0 mmol/l or a reduction of 25% frombaseline. The percentage reduction approach is needed for patientsstarting statin treatment for secondary prevention or becauseof their high cardiovascular risk but whose total cholesterolvalue is already close to the target. For example, for suchpatients starting statin treatment with a total cholesterolof 4.1 mmol/l, lowering cholesterol to 3.9 mmol/l is clearlynot sufficient and a 25% reduction is required.

Many people in the United Kingdom are indeed unaware that theyhave a raised blood pressure and are therefore at increasedrisk. Most will develop more serious hypertension over time.How will that be detected without a programme of monitoring?It may not be cost effective for Green to do it, but somebodyshould. The "real world of general practice" cannot meet thechallenges of modern . . . [Full text of this article]

Bryan Williams, guideline working party chairman

Department of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, University of Leicester, Leicester bw17@leicester.ac.uk

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