Cardiovascular disease prevention: lipid lowering therapy for people newly diagnosed with hypertension or T2DM

Indicator

IND287. In those patients aged between 25 and 84 years, with a new diagnosis of hypertension or type 2 diabetes recorded in the preceding 12 months (excluding those with pre-existing cardiovascular disease [CVD], chronic kidney disease, familial hypercholesterolaemia or type 1 diabetes), who have a recorded cardiovascular risk assessment score of 10% or more in the preceding 12 months: the percentage who are currently treated with a lipid lowering therapy.

Resource impact

The previous indicator IND162 was as follows:

In those patients aged between 25 and 84 years, with a new diagnosis of hypertension or type 2 diabetes recorded in the preceding 12 months (excluding those with pre-existing CVD, chronic kidney disease, familial hypercholesterolaemia or type 1 diabetes), who have a recorded cardiovascular risk assessment score of more than 20% in the preceding 12 months: the percentage who are currently treated with statins (unless there is a contraindication).

IND287 updates and replaces IND162 and expands the lipid lowering therapies in the indicator beyond statins as well as amending the relevant population to be consistent with NICE's guideline on cardiovascular disease: risk assessment and reduction, including lipid modification.

The indicator aims to reduce CVD risk and prevent future cardiovascular events in people with a new diagnosis of hypertension or type 2 diabetes. Atorvastatin 20 mg is recommended as the preferred high-intensity statin for primary prevention of CVD but alternative statins or lipid lowering treatment could be used if atorvastatin 20 mg is contraindicated, not tolerated or does not result in a greater than 40% reduction in non-HDL cholesterol. All other modifiable CVD risk factors should be optimised before lipid lowering therapy is offered.

Clinical Practice Research Datalink (CPRD) data indicates that the number of people aged between 25 and 84 years with a new diagnosis of hypertension or type 2 diabetes in the preceding 12 months (without exclusions) and had a recorded CVD risk assessment score of 10% or more in the preceding 12 months, is around 33 per 10,000 population.

The proposed indicator amends the relevant population, widens the lipid-lowering therapies in the indicator and applies to a relatively small number of people per average practice. Any associated resource impact is therefore unlikely to be significant.