Letters NICE on lipid modification

NICE’s simplified approach can’t not work

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39619.524907.3A (Published 26 June 2008) Cite this as: BMJ 2008;336:1454
  1. Magnus I Hird, pharmacist practitioner
  1. 1Bloomfield Medical Centre, Blackpool FY1 6JW
  1. magnus.hird{at}blueyonder.co.uk

    Laurie writes that a proportion of patients started on simvastatin 40 mg for secondary prevention will not achieve total and low density lipoprotein cholesterols of less than 4 mmol/l and 2 mmol/l, respectively.1 He is quite right: even in the trials of the most aggressive statin treatment, about half of patients do not reach these levels, a point emphasised by the National Institute for Health and Clinical Excellence (NICE) in its recent guideline.2

    Laurie suggests starting with an …

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