Authors' objectives:

This report considers whether cholesterol screening is worthwhile and examines the effectiveness and cost-effectiveness of the statins and a range of other interventions to reduce CHD. It aims to provide a summary of the research evidence which can be used to establish cost-effective policies for reducing CHD

Authors' recommendations: Despite the declining coronary heart disease (CHD) mortality rate, CHD remains a major cause of premature death and imposes high personal, social and economic costs. Blood cholesterol is an important risk factor for CHD but should be considered in the context of other risk factors such as smoking, raised blood pressure and physical inactivity. Blood cholesterol alone is a relatively poor predictor of individual CHD risk. The majority of CHD events occur in people with average or low blood cholesterol levels. Consequently, cholesterol screening is unlikely to reduce mortality and can be misleading or even harmful. Cholesterol lowering using statins is effective at reducing CHD mortality and morbidity. Therapy should be targeted at people who are at high risk of coronary heart disease rather than be based upon cholesterol levels. In asymptomatic people, at low risk of coronary heart disease, the costs of cholesterol lowering using statins are high relative to the benefits and their use is contentious. Cholesterol lowering is one of a number of methods of reducing the risk of cardiovascular disease. The cost-effectiveness of some anti-hypertensives, aspirin and beta-blockers is greater than statins. Greater priority should be given to the appropriate use of other drug treatments and non-pharmacological interventions in the primary and secondary prevention of coronary heart disease.

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/ehcb.htm

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination