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Lipid modification

Cardiovascular risk assessment: the modification of blood lipids for the primary and secondary prevention of cardiovascular disease.

Status: History
Publication date: May 2008
Wave: 9
Process: CG
Topic area:
 

NICE project team

Centre for clinical practice lead: Gillian Leng
Communications manager: Phil Ranson
Guidelines commissioning manager: Sarah Willett
Guidelines coordinator: Andrew Gyton
Patient involvement lead: Victoria Thomas
Guidelines Development Group: The Guideline Development Group (GDG) oversees the development process.
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Email enquiries

If you have any queries please email nice@nice.org.uk
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Provisional schedule

Scoping workshop: 11 April 2005
Consultation on draft scope with stakeholders: 24 May - 29 April 2005
Consultation on draft guideline with stakeholders: 27 June - 22 August 2007
Pre-publication check: TBC
Publication date: May 2008
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Project history

Date Update
24 December 2003 The remit (see link below) was received from the Department of Health and the Welsh Assembly Government in October 2003 as part of the Institute's 9th wave work programme.
5 April 2004 Patient Involvement Lead added.
24 August 2004 Executive lead updated.
3 March 2005 Date of issue, contact details and provisional schedule updated.
24 March 2005 The draft scope (see link below) is out for consultation with stakeholders. The scope defines what aspects of care the guideline will cover and to whom it will apply. If you wish to comment, you need to do so via one of the registered stakeholder organisations listed above, by the deadline shown.
24 August 2005 The scope (see link below) defines what aspects of care are covered by the guidance and to whom it applies.
2 September 2005 Date of First Guideline Development Group meeting added.
7 October 2005 List of stakeholders updated
8 September 2006 Guidelines Coordinator changed to Bijal Chandarana
4 December 2006

The Institute is currently preparing clinical guidelines on 'MI: Secondary Prevention' (scheduled publication March 2007), and on 'Cardiovascular risk assessment: the modification of blood lipids for the primary and secondary prevention of cardiovascular disease' (scheduled publication December 2007). The guidelines have been developed alongside the technology appraisal advice on Statins for the prevention of cardiovascular events (published January 2006), and also Ezetimibe for the treatment of hypercholesterolemia (scheduled publication August 2007).

The scope for the MI;Secondary Prevention states that it will provide advice on 'lipid modifying drugs with specific reference to the additional advice for patients post MI and incorporating the statins technology appraisal and cross referencing to the hyperlipidaemia guideline'.

In the light of the more detailed recommendations being developed in the Lipids Modification guideline, the Institute has agreed the most appropriate way forward is for the MI guideline to confine its recommendations to those in the technology appraisal on Statins, and does not include recommendations on dosage or cholesterol monitoring etc. The Lipids guideline will then take on responsibility for making recommendations regarding statin doses and targets, and include recommendations for patients following an MI.

4 December 2006 List of stakeholders updated.
7 March 2007 List of stakeholders updated.
26 June 2007 The consultation draft of the guideline is out for consultation with stakeholders. If you wish to comment, you need to do so via one of the registered stakeholder organisations listed above, by the deadline shown
4 July 2007 A new consultation draft version of the Lipid Modification guideline has been made available on this webpage. The only changes to the documents refer to recommendations on the use of the drug ezetimibe.  NICE is developing a technology appraisal on ezetimibe for the treatment of hypercholesterolaemia, and these recommendations will be updated once the technology appraisal guidance has been finalised, in line with NICE's standard process. The technology appraisal is scheduled to be published in November 2007, and the guideline in January 2008. We would like to apologise for any confusion or inconvenience this has caused, and remind you that the guideline consultation ends on Wednesday 22 August 2007.
24 August 2007 Consultation on the draft of the guideline is complete and the guideline is being modified in the light of comments received.
29 October 2007

Delay to lipid modification clinical guideline - for information
As you will be aware, the clinical guideline on Lipid Modification covering the estimation of cardiovascular risk and the use of interventions to modify blood lipids in the primary and secondary prevention of cardiovascular disease, is due to be published in January 2008.

The equation used to estimate cardiovascular risk is central to the guideline and the recommendation in the draft guideline is to use the Framingham equations. There are, however, some commonly acknowledged problems applying the Framingham equations in England and Wales in particular because they tend to overestimate risk in most of our population, but underestimate risk in some groups.
Recently, a new equation, QRISK, has been developed using English data which appears to perform better in the English population than Framingham. QRISK was published while the NICE guideline was out for consultation, with some subsequent debate and corrections. The Guideline Development Group (GDG) felt it was premature to recommend QRISK at that time. Subsequently, a further validation of QRISK has been published.

In the light of this, NICE has asked the GDG to assess the second validation study and reconsider their recommendations on risk estimation and to seek advice on technical issues from independent experts. Should there be substantive changes to the recommendations, a second, four week, consultation period will be required. The timing of any consultation, together with a revised publication date, will be published on the NICE website shortly.

29 November 2007 Project team updated.
11 February 2008 Section 4.3 of the full guideline is out for consultation with stakeholders. If you wish to comment, you need to do so via one of the registered stakeholder organisations listed above, by the deadline shown.
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Key documents

This page was last updated: 03 August 2011

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.