Trigger Happy GPs

The majority of doctors admit they would prescribe statins (cholesterol lowering medication) to patients at low risk of heart disease and stroke, a study has revealed.

In the survey of US-based GPs and cardiologists, nearly 90% said they would recommend statins for a 40-year-old male who had elevated LDL cholesterol and hypertension but no other risk factors, despite their being at low absolute risk.

In another scenario, almost 75% of doctors said they would prescribe for a 50-year-old woman who had high LDL cholesterol but no other risk factors – also not a candidate for statins under current guidelines.

The study authors, from the University of Michigan’s department of family medicine, said the study showed cardiovascular risk was inconsistently assessed by some doctors. “We found that physicians consider medication for patients with low Framingham risk scores (<5%) for whom available evidence does not support outcome benefit,” they said.

Further reading: Cholesterol drugs today’s Vitamin C?

The anonymous survey involved 202 doctors who were presented with six different hypothetical patient scenarios. Despite recommendations to focus on absolute cardiovascular risk, doctors tended to overemphasise the importance of cholesterol levels and underemphasise the significance of diabetes, the researchers said.

There was no significant difference in approach between cardiologists and GPs. The RACGP’s Red Book recommends statins be considered only for people with an absolute cardiovascular risk of 10% or above, using the calculator at Even then, six months of intensive lifestyle counselling is advised as a first-line approach.

Kate Cowling,

Reference: JAMA Intern Med. 2013;():1-2. doi:10.1001/jamainternmed.2013.2797.

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