Statin prescribing for primary prevention of cardiovascular disease: a cross-sectional, observational study
Statin prescribing for primary prevention of cardiovascular disease: a cross-sectional, observational study
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DOI：
10.3399/bjgp15x686113
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发表时间：
2015-08-01
影响因子：
5.9
通讯作者：
Robson, John
中科院分区：
文献类型：
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作者：
Homer, Kate;Boomla, Kambiz;Robson, John
背景更新后的（2014年）美国国家健康与护理卓越研究所（NICE）指南将他汀类药物处方的推荐阈值从20%降低至10% 10年心血管疾病（CVD）风险。目的确定根据其心血管疾病风险开他汀类药物进行一级预防的患者的特征。设计和设置在东伦敦三个CCG的初级保健机构中进行的横断面研究（纽汉、城市和哈克尼以及陶尔哈姆莱茨）。方法数据提取自截至2014年4月1日的一年内141个普通诊所中的137个诊所登记的930 000名患者的电子健康记录。22393人服用他汀类药物，并记录了10年的CVD风险。其中，9828（43.9%）心血管疾病风险>= 20%，7121（31.8%）有10- 19%的心血管疾病风险，（24.3%）有CVD风险= 20%CVD风险，7121/37111（19.2%）有CVD风险10- 19%，5444/146676（3.7%）有CVD风险<10%。他汀类药物处方低于20%CVD风险阈值的目标个人在10-19%的风险带与高血压，高血清胆固醇，阳性家族史，年龄较大，和南亚ethnication.ConclusionThis研究证实继续治疗不足的患者在最高的CVD风险（>= 20%）。全科医生只给10-19%风险范围内的五分之一的人开了他汀类药物，通常与已知的主要风险因素有关。在低于10%的人群中，只有3.7%的人服用了他汀类药物。
BackgroundThe updated (2014) National Institute for Health and Care Excellence (NICE) guideline lowered the recommended threshold for statin prescription from 20% to 10% 10-year cardiovascular disease (CVD) risk.AimTo determine the characteristics of patients prescribed statins for primary prevention according to their CVD risk.Design and settingCross-sectional study in primary care settings in the three east London CCGs (Newham, City and Hackney, and Tower Hamlets).MethodData were extracted from electronic health records of 930 000 patients registered with 137 of 141 general practices for a year ending 1 April 2014.ResultsOf 341 099 patients aged 30-74 years, excluding those with CVD or diabetes, 22 393 were prescribed statins and had a 10-year CVD risk recorded. Of these, 9828 (43.9%) had a CVD risk >= 20%, 7121 (31.8%) had a CVD risk of 10-19%, and 5444 (24.3%) had a CVD risk = 20% CVD risk, to 7121/37 111 (19.2%) of those with CVD risk 10-19%, and to 5444/146 676 (3.7%) of those with CVD risk < 10%. Statin prescription below the 20% CVD risk threshold targeted individuals in the 10-19% risk band in association with hypertension, high serum cholesterol, positive family history, older age, and south Asian ethnicity.ConclusionThis study confirms continuing undertreatment of patients at highest CVD risk (>= 20%). GPs prescribed statins to only one-fifth of those in the 10-19% risk band usually in association with known major risk factors. Only 3.7% of individuals below 10% were prescribed statins.