NICE lipid guidance branded 'obsolete'

The NICE lipid modification guidelines have failed to take into account latest research and have been branded 'obsolete' by a heart expert.

Writing in an editorial in the journal Heart, Professor Anders Olsson, from the University of Linkoping, criticises the NICE guidance for using the Framingham risk tool which is based on an American population rather than a risk tool more suited to a European population.

Professor Olsson recommends that a modified version of the HeartSCORE tool, which has been adopted and applied to local populations in specific European countries, is adopted by NICE instead.

He goes on to say that the NICE guidance should take onboard recent research and introduce apolipoproteins into the risk estimation.

‘The ratio of apolipoprotein B to apolipoprotein A-1 has repeatedly been demonstrated to better define cardiovascular risk than LDL cholesterol and HDL cholesterol.’

Professor Olsson adds that the waist/hip ratio should also be used to define obesity-mediated additional cardiovascular risk instead of BMI.

‘Waist-hip ratio has repeatedly been demonstrated to better indicate the additional risk being mediated through increased obesity,’ he says.

sanjay.tanday@haymarket.com

Heart 2008; 94:1256-1257

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