NICE guidance on cardiovascular disease risk assessment and reduction is disappointing

As a general practitioner, I regularly spend 20 minutes wading through treacle in a 10 minute appointment slot to discuss cholesterol, usually under the problem heading “NHS Health Check completed.” I responded to the call for contributions to the National Institute for Health and Care Excellence’s guideline on cardiovascular disease risk assessment and reduction,1 saying that the QRISK 10 year calculators (https://www.qrisk.org/index.php) put every man over 60 and every woman over 70 at a >10% risk of cardiovascular disease, and therefore testing for cholesterol or discussing NICE guidelines in these age groups is a waste of time and resources—the guidelines might as well recommend statins for anyone of this age. Cholesterol concentration is a genetic setting, so repeatedly re-testing also seems wasteful to me.It is disappointing to see the guidelines recommend the assumption that everyone over 85 is at risk of disease or death and to consider how many minutes…
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