TY - JOUR T1 - Why are statin prescribing guidelines for primary prevention not always followed in primary care? JF - British Journal of General Practice JO - Br J Gen Pract SP - 536 LP - 537 DO - 10.3399/bjgp16X687481 VL - 66 IS - 651 AU - Yasmeen Hassan AU - John Ford AU - Nicholas Steel AU - Joanna Sheldon AU - Robert Fleetcroft Y1 - 2016/10/01 UR - http://bjgp.org/content/66/651/536.abstract N2 - Cardiovascular disease (CVD) is a major cause of mortality accounting for 27% of deaths in the UK in 2014 and is a great cost to the UK economy, estimated to be £15.2 billion in 2015.1 Lipid modification is important as there is a positive correlation between the incidence of CVD and cholesterol levels.2 There is substantial evidence of benefit in prescribing statins to all patients for secondary prevention of CVD and for primary prevention in many of those patients with higher CVD risk.3 A Cochrane review in 2013 included 18 randomised controlled trials of statin prescribing for primary prevention and reported a reduction in all-cause mortality (odds ratio [OR] 0.86, 95% confidence interval [CI] = 0.79 to 0.94), with the number needed to treat to prevent one death over 5 years being 96 and an acceptable cost-effectiveness.3 The Cholesterol Treatment Trialists’ Collaboration (CTTC) trial performed a meta-analysis of individual patient data from 27 randomised controlled trials and reported in 2012 that statin therapy reduces the risk of major vascular events even in patients with 5-year CVD risks of <5%.2The National Institute for Health and Care Excellence (NICE) guidance recommends the use of the QRISK2 tool to assess CVD risk, and treatment with statins at a >10% 10-year risk of developing CVD. This guidance was revised from a >20% risk in 2014 and a >30% risk in 2010.4 … ER -