UK docs urged to fight heart disease aggressively
Britain’s generalist doctors (GPs) on Wednesday were given tougher targets to help prevent the nation’s biggest killer— heart disease—including prescribing more drugs for at-risk groups as well as some seemingly healthy people.
Issuing new guidelines, the Joint British Societies - a group of six medical bodies, said: “For all high risk people a number of drugs from different classes will reduce the risk of recurrent disease and increase life expectancy.”
The 61-page guidance, which includes risk prevention charts, is published by the journal Heart, part of the British Medical Association’s publishing arm, and is likely to be adopted as best practice by the UK’s GPs.
The guidance says GPs should pay equal attention to patients from three groups - those with established cardiovascular disease, diabetics, and the seemingly healthy who, after investigation, are found to have a 20 percent or higher chance of developing atherosclerotic disease within 10 years.
This last group should be established by comprehensive risk assessments that take into account ethnicity (because of the 1.4-times higher risk in people from the Indian subcontinent), smoking, family history of cardiovascular disease, weight, waist circumference, blood pressure, non-fasting lipids, and non-fasting glucose.
The same tests should be carried out on younger people with a family history of premature atherosclerotic disease or younger diabetics.
The Joint Societies say GPs should encourage healthier living in at-risk patients but also point out that drugs for use in heart disease are well established and can be prescribed confidently. “Cardiovascular protective drug therapy should be considered in all high risk people and prescribed selectively at the doses which efficacy and safety have been shown in clinical trials.”
The prevalence of coronary heart disease and stroke in 2003 among all age groups was 9.1 percent in British males and 6.3 percent in females.
In the age group 65 to 74 years, it was 26 percent and 14 percent respectively, and in the group aged 75 years and over it was 34 percent and 25 percent respectively.
The Joint British Societies are the British Cardiac Society, British Hypertension Society, Diabetes UK, Heart UK, Primary Care Cardiovascular Society, Stroke Association.
SOURCE: Heart supplement, December 2005.
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