{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T06:44:00Z","timestamp":1777099440311,"version":"3.51.4"},"reference-count":24,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,12,21]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In 2014, guidelines from the National Institute for Health and Care Excellence (NICE) provided updated recommendations on lipid-modifying therapy (LMT). We assessed clinical practice contemporaneous to release of these guidelines in a UK general practice setting for secondary and high-risk primary-prevention populations, and extrapolated the findings to UK nation level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients from The Health Improvement Network database with the following criteria were included: lipid profile in 2014 (index date); \u226520\u2005years of age; \u22652\u2005years representation in database prior to index; \u22651 statin indication either for atherosclerotic cardiovascular disease (ASCVD) or the non-ASCVD conditions high-risk diabetes mellitus and\/or chronic kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 183\u2005565 patients met the inclusion criteria (n=91\u2005479 for ASCVD, 92\u2005086 for non-ASCVD). In those with ASCVD, 79% received statin treatment and 31% received high-intensity statin. In the non-ASCVD group, 62% were on a statin and 57% received medium-intensity or high-intensity statin. In the ASCVD and non-ASCVD cohorts, 6% and 15%, respectively, were already treated according to dosing recommendations as per updated NICE guidelines. Extrapolation to the 2014 UK population indicated that, of the 3.3 million individuals with ASCVD, 2.4 million would require statin uptitration and 680\u2005000 would require statin initiation (31% de novo initiation, 60% reinitiation, 9% addition to non-statin LMT) to achieve full concordance with updated guidelines. Of the 3.5 million high-risk non-ASCVD individuals, 1.6 million would require statin uptitration and 1.4 million would require statin initiation (59% de novo initiation, 36% reinitiation, 5% addition to non-statin LMT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A large proportion of UK individuals with ASCVD and high-risk non-ASCVD received statin treatment (79% and 62%, respectively) during the year of NICE 2014 guidelines release. Up to 94% of patients with ASCVD and 85% of high-risk non-ASCVD individuals, representing \u223c3 million individuals in each group, would require statin uptitration or initiation to achieve full concordance with updated guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013255","type":"journal-article","created":{"date-parts":[[2017,2,17]],"date-time":"2017-02-17T20:55:18Z","timestamp":1487364918000},"page":"e013255","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Retrospective examination of lipid-lowering treatment patterns in a real-world high-risk cohort in the UK in 2014: comparison with the National Institute for Health and Care Excellence (NICE) 2014 lipid modification guidelines"],"prefix":"10.1136","volume":"7","author":[{"given":"Dylan L","family":"Steen","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irfan","family":"Khan","sequence":"additional","affiliation":[{"name":"Global Health Economics and Outcomes Research, Sanofi, Bridgewater, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ansell","sequence":"additional","affiliation":[{"name":"IMS Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Global Health Economics and Outcomes Research, Regeneron Pharmaceuticals Inc., Tarrytown, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kausik K","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,2,17]]},"reference":[{"key":"2025121222134977000_7.2.e013255.1","unstructured":"World Health Organization. Health statistics and information systems: estimated deaths (\u2018000) by cause, sex and WHO member state, 2012. http:\/\/www.who.int\/entity\/healthinfo\/global_burden_disease\/GHE_Deaths_2012_country.xls?ua=1 (accessed 14 Jan 2016)."},{"key":"2025121222134977000_7.2.e013255.2","unstructured":"Institution for health metrics and evaluation. Global burden of disease calculator: United Kingdom, 2013. http:\/\/vizhub.healthdata.org\/gbd-compare. 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