BMJ  2008;336:288-289 (9 February), doi:10.1136/bmj.39387.573947.80

Editorials

Strategies for prescribing statins

Evidence supports prescribing a standard dose without further testing or dose adjustment

The first 150 words of the full text of this article appear below.

Five years ago the "fire and forget approach" was proposed as a strategy for prescribing lipid lowering drugs.¹ It involves prescribing a standard dose of statins to patients at high risk of cardiovascular disease without further testing or dose adjustment. This strategy was contrasted to the "treat to target strategy," which aims to achieve target concentrations of low density lipoprotein by titrating drugs and other measures accordingly.

Since then, several trials have shown that high dose statins in a supposed treat to target approach are more effective than the standard dose. Accordingly, the United Kingdom quality and outcomes framework and the Scottish Intercollegiate Guidelines Network guideline number 97 emphasise the importance of measuring cholesterol and having targets.² So, is the treat to target strategy now the best option?

None of the large statin trials used the treat to target strategy suggested by most lipid experts, and none was based on . . . [Full text of this article]

¹ Department of General Practice, University of Marburg, D-35032 Marburg, Germany, ² Institute of General Practice, Family Medicine and Prevention, Paracelsus Medical University, A-5020 Salzburg, Austria

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This article has been cited by other articles:

• Lewis, L S. (2008). The CASE for fire and forget. BMJ 336: 406-406 [Full text]  
• Mackenzie, D G., Rutledge, P. (2008). Treat to target benefits no one. BMJ 336: 406-406 [Full text]  

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