A regional approach to lipid management

This National Cholesterol Month, we are sharing a series of articles, providing practical tips from regional experts, to support the primary care workforce in preventing and managing cardiovascular disease (CVD).

In our second installment of the series, Dr Pete Carey discusses the regional approach that the North East and North Cumbria have developed, towards lipid management.

Dr Pete Carey, Consultant in Diabetes and Endocrinology, South Tyneside and Sunderland NHS Foundation Trust and Chair, Lipid Specialist Advisory Group, said:

“Cardiovascular disease accounts for one in four deaths in the UK. These are conditions that can largely be prevented. It’s the area in which we can have the most impact in terms of saving lives. If we focus on reducing risk, we can reduce the number of people having heart attacks, strokes and developing dementia.

“As healthcare professionals, we can support patients in reducing their risks through lipid optimisation to lower their cholesterol levels. We have established drugs such as statins and ezetimibe that have been proven to be highly effective, as well as new therapies that enable us to achieve significant further reductions in cholesterol.

“The use of Primary Care data searches that have been developed locally, enables us to identify individuals with Familial Hypercholesterolemia (FH), who have a high risk of heart disease and premature death.

“In the North East and North Cumbria, we have developed a regional approach to lipid management. We’ve developed the Northern England Evaluation and Lipid Intensification (NEELI) guidelines to ensure optimal lipid management is achieved for patients.

“The guidelines enable healthcare professionals to implement best practice principles to treat and manage people with cardiovascular disease in line with local and national guidance and provide supplementary information around areas not covered by NICE. As a region, we were early adopters of a secondary prevention Non HDL-C target < 2.5 mmol/l (equivalent to a LDL-C < 1.8 mmol/L) that has been subsequently adopted by the AAC pathway and the new NICE QOF targets.

“It’s important that Lipid Clinics work in collaboration with GPs, Practice Nurses and Community Pharmacists as well as Hospital Specialists dealing with cardiovascular disease to make sure that we are able to help our patients reduce their risk of cardiovascular disease as much as possible.”

Read Dr Tim Butler’s article, which highlights how primary care staff can work together, to improve patient outcomes for people at risk of CVD, here.

Resources

A quick guide to calculating LDL cholesterol

  1. Visit https://www.mdcalc.com/calc/70/ldl-calculated
  2. Before entering lipid results, change calculations from mg/dL to mmol/L by clicking on the boxes of the same name (note you will need to do this for all three boxes as this website defaults to the European units, rather than UK)
  3. Enter all three calculations for LDL result

To access the NEELI Guidelines, click here: NEELI Guidelines

To find out more about the Lipid Management Pathway, visit: Lipid Management Pathway – Health Innovation NENC

To access resources for primary care, visit: Resources for Primary Care – Health Innovation NENC