The latest quality standard published by NICE aims to help health professionals prevent thousands of people from becoming ill and dying prematurely from heart attacks, strokes and peripheral arterial disease. The quality standard covers identifying and assessing cardiovascular risk in adults, and, where it is necessary, using statins to reduce levels of harmful cholesterol in order to prevent cardiovascular disease (CVD).
Although fewer people are dying as a result of CVD, it is still the leading cause of death in England and Wales, accounting for almost onethird of all deaths. In 2010, 180,000 people died from CVD – around 80,000 of these deaths were caused by coronary heart disease and 49,000 were caused by strokes.
The quality standard includes nine statements aimed at healthcare professionals caring for people in danger of developing CVD, or who already have CVD. These include:
- Adults under 85 who have been identified with an estimated increased risk of CVD should be offered a full formal risk assessment using the QRISK2 tool.
- Adults with a 10-year risk of CVD exceeding 10% should receive advice on lifestyle changes before any offer of drug intervention.
- Adults with a 10-year risk of CVD exceeding 10% should be assessed for secondary causes of hyperlipidaemia before any offer of statin therapy.
- Adults with a 10-year risk of CVD exceeding 10% for whom lifestyle changes are ineffective or inappropriate should have a discussion on the risks and benefits of starting statin therapy.
The quality standard for cardiovascular risk assessment and lipid modification is available on the NICE website at http://www.nice.org.uk/ guidance/qs100. NICE has also published a quality standard on preventing heart attacks (myocardial infarction, or MI) in people who have already had a heart attack, including the use of cardiac rehabilitation. The quality standard on secondary prevention following myocardial infarction is available at http://www.nice.org.uk/guidance/qs99
