Does implementation of the European guidelines based on the SCORE model double the number of Norwegian adults who need cardiovascular drugs for primary prevention? The Tromsø study 2001

Abstract

The implementation of the European guidelines could imply a doubling of the numbers of Norwegian adults on cardiovascular medication for primary prevention. Contributors to the increase would be more frequent drug use in men and elderly people, particularly for LLD use.

Why do sales of lipid-lowering drugs vary between counties in Norway?

“…The gap between observed and guideline-recommended LLD use may reflect the fact that adherence to Framingham-based thresholds for intervention has been problematic in clinical practice. Norwegian population studies have shown that European SCORE-based guidelines classify most adults at high CVD risk with an ''unfavourable'' high cholesterol [2,5,6]. Implementation of these guidelines may lead to a marked increase in pharmacological treatment, especially in men and among the elderly [5].…”

“…Norwegian population studies have shown that European SCORE-based guidelines classify most adults at high CVD risk with an ''unfavourable'' high cholesterol [2,5,6]. Implementation of these guidelines may lead to a marked increase in pharmacological treatment, especially in men and among the elderly [5]. Hence, we would expect a continuance in regional differences in LLD sales.…”

“…However, whereas implementation of the guidelines could imply a larger part of the population on cardiovascular preventive therapy in the future [5,6], variation in lipid-lowering drug (LLD) sales across Scandinavia and the rest of Europe may reflect uncertainty about how to manage existing guidelines in clinical practice [7]. The variations in LLD use between countries have been little investigated, but may be explained by differences in national treatment guidelines and drug reimbursement systems, as well as variations in cardiovascular morbidity [8,9].…”

An evaluation of the performance of SCORE Sweden 2015 in estimating cardiovascular risk

“…As Norway has one of the highest predicted lifespans the findings seemed to invalidate the predictive ability and clinical performance of SCORE in this population, and issues regarding ethical dilemmas associated with risk labelling and medicalisation were also raised. [19][20][21][22] The version of SCORE used was outdated, however, and needed recalibration.…”

A Ten Year Overview of Surgical and Interventional Arrhythmology in Russia. Service Peculiar Features in the Far East

“…Результаты норвежского исследования показывают, что использование европейской шкалы SCORE удвоит коли-чество лиц, нуждающихся в препаратах для первичной профилактики ССЗ [548] . В данную группу лиц будут включены мужчины и пожилые люди, которые имеют показания к приему гиполипидемических препаратов .…”