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Ueda and colleagues address the 2014 NICE guidelines based on QRISK 2 in commendable fashion. It would be interesting to ask them for their opinion on an article very recently published in the Pharmaceutical Journal entitled The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance1 which would appear to undermine the very foundations on which QRISK and the NICE guidelines totter.
Not only is there an issue of with whether the patient in the consulting room meets the inclusion criteria of the studies which went towards the formulation of any guideline, but also the semantics involved in the word 'guideline' which is fundamentally different from 'code' (must do). [Definition of CODE: A collection or compendium of laws. A complete system of positive law, scientifically arranged, and promulgated by legislative authority].
What is a poor jobbing GP to do in a 10-minute consultation when the patient sitting opposite is still worrying what their cholesterol level is and grappling with the far more important QRISK2 odds concept, while empirical science puts cholesterol in the dustbin alongside the multitude of historical medical fashions which in their time were cutting edge 'must do's'?
'Primum non nocere' would suggest sitting on one's hands as one of the safest of options while prescribing a statin among the most d...
Show MoreCompeting Interests: None declared.