Strategies for prescribing statins

doi:10.1136/bmj.39387.573947.80

BMJ 2008;336:288-289 (9 February), doi:10.1136/bmj.39387.573947.80

Editorials

Strategies for prescribing statins

Evidence supports prescribing a standard dose without furthertesting or dose adjustment

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

Five years ago the "fire and forget approach" was proposed asa strategy for prescribing lipid lowering drugs.¹ It involvesprescribing a standard dose of statins to patients at high riskof cardiovascular disease without further testing or dose adjustment.This strategy was contrasted to the "treat to target strategy,"which aims to achieve target concentrations of low density lipoproteinby titrating drugs and other measures accordingly.

Since then, several trials have shown that high dose statinsin a supposed treat to target approach are more effective thanthe standard dose. Accordingly, the United Kingdom quality andoutcomes framework and the Scottish Intercollegiate GuidelinesNetwork guideline number 97 emphasise the importance of measuringcholesterol and having targets.² So, is the treat to targetstrategy now the best option?

None of the large statin trials used the treat to target strategysuggested by most lipid experts, and none was based on . . . [Full text of this article]

Norbert Donner-Banzhoff, professor of general practice¹, Andreas Sönnichsen, professor of general practice²

¹ Department of General Practice, University of Marburg, D-35032 Marburg, Germany, ² Institute of General Practice, Family Medicine and Prevention, Paracelsus Medical University, A-5020 Salzburg, Austria

norbert@med.uni-marburg.de

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This article has been cited by other articles:

Donner-Banzhoff, N., Sonnichsen, A. (2008). Statins and primary prevention of cardiovascular events. BMJ 337: a2576-a2576 [Full text]
Lewis, L S. (2008). The CASE for fire and forget. BMJ 336: 406-406 [Full text]
Mackenzie, D G., Rutledge, P. (2008). Treat to target benefits no one. BMJ 336: 406-406 [Full text]

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