Best practice principles for cholesterol lowering

In 2006, 78% of patients with coronary heart disease (CHD) achieved the National Quality and Outcomes Framework (QOF) of the General Medical Services (GMS) target of 5.0 mmol/L for total cholesterol. This is a significant achievement in secondary prevention and shows that the standard of care in the UK is becoming aligned with that of the rest of Europe. Nevertheless, the UK still has one of the highest CHD mortality rates in Europe, and we need therefore to continue to work towards improving the quality of care and achieving more clinically meaningful targets for high-risk patients. The current targets outlined by the GMS for lipid lowering are less stringent than the newer evidence-based recommended targets of <4.0 mmol/L for total cholesterol and <2.0 mmol/L for low-density lipoprotein cholesterol (LDL-C) suggested by the recent Joint British Societies' Guidelines on Prevention of Cardiovascular Disease in Clinical Practice (JBS2). This supplement outlines a new treatment algorithm for suggested best practice for cholesterol lowering, incorporating the latest strategies and thinking.