QRISK and Statins

[Jenny65]

Hi all

I had my follow up appointment with my GP to discuss my blood test results. We discussed my cholesterol level which hasnt reduced since the previous test (7.4) He found it odd as it was clear my weight loss and BG was going down. He did my QRISK assessment which he looked at my age, my weight, BMI, blood pressure, BG level, and my cholesterol, plus there being no family history of cardiac issues and it came back as 5, he said anything 10 or over and he would advise statins but at 5 its pretty low and he is happy with my keeping on with my diet and monitoring.

I was pleasantly surprised as thought he would try and persuade me to have medication. The things in my favour he said were my low blood pressure, being in remission and having no family history of heart problems. He said he did it again and listed me as diabetic and it came back as 11 but he said if I keep my BG the same or lower he thinks I am low risk.

This is the first time I have heard of this test but thought I would share as they did take all factors into consideration to ensure I am treated apporpriately. He is referring me for a bone density scan and another follow up blood test in 3 months.

 

[Jenny65]

Hi all

I had my follow up appointment with my GP to discuss my blood test results. We discussed my cholesterol level which hasnt reduced since the previous test (7.4) He found it odd as it was clear my weight loss and BG was going down. He did my QRISK assessment which he looked at my age, my weight, BMI, blood pressure, BG level, and my cholesterol, plus there being no family history of cardiac issues and it came back as 5, he said anything 10 or over and he would advise statins but at 5 its pretty low and he is happy with my keeping on with my diet and monitoring.

I was pleasantly surprised as thought he would try and persuade me to have medication. The things in my favour he said were my low blood pressure, being in remission and having no family history of heart problems. He said he did it again and listed me as diabetic and it came back as 11 but he said if I keep my BG the same or lower he thinks I am low risk.

This is the first time I have heard of this test but thought I would share as they did take all factors into consideration to ensure I am treated apporpriately. He is referring me for a bone density scan and another follow up blood test in 3 months.

He kept saying how he found it odd that all my results were identical to the last test, he almost hinted it was an error, I do wonder bearing in mind my very first blood test came back that I didn't have diabetes when I in fact very much did!

 

[Deleted member 21371]

He kept saying how he found it odd that all my results were identical to the last test, he almost hinted it was an error, I do wonder bearing in mind my very first blood test came back that I didn't have diabetes when I in fact very much did!

I'd just push for a second test, if "error" was suggested?

 

[42istheanswer]

If it has come back the same on separate occasions, my personal guess would be that it may mean that there is a factor other than the ones you have fixed that is causing it. Lab error is no more likely to give the exact same number as the first test than to give another number. I do agree with @travellor that if your GP thinks it may be an error then they should be suggesting repeating it.

Kind of an aside really, but do you know if he did QRisk2 or QRisk3? Officially the recommendation is supposed to be QRisk3 now but I don't know if all GP surgeries have switched. (They basically made it a bit more sophisticated). I think mine is slightly lower on 3 than 2, or is it the other way around? Whichever one you can put postcode in gave me a risk above 10% if you put in my current postcode, but below 10% if you put in the postcode of where I was born/grew up - which given so many assessments of determinants of health suggest that life expectancy is greatly affected by place of birth I wonder if that is the correct one to use.

 

[Sharron1]

If it has come back the same on separate occasions, my personal guess would be that it may mean that there is a factor other than the ones you have fixed that is causing it. Lab error is no more likely to give the exact same number as the first test than to give another number. I do agree with @travellor that if your GP thinks it may be an error then they should be suggesting repeating it.

Kind of an aside really, but do you know if he did QRisk2 or QRisk3? Officially the recommendation is supposed to be QRisk3 now but I don't know if all GP surgeries have switched. (They basically made it a bit more sophisticated). I think mine is slightly lower on 3 than 2, or is it the other way around? Whichever one you can put postcode in gave me a risk above 10% if you put in my current postcode, but below 10% if you put in the postcode of where I was born/grew up - which given so many assessments of determinants of health suggest that life expectancy is greatly affected by place of birth I wonder if that is the correct one to use.

I just tried the QRisk3 calculator and put in my current post code the result was way below 10%. Thought i would put in my childhood post code and that was close to 10% .Then i had another go with and without type 2 diabetes, the no diabetes was much lower that the yes to type 2 .At that point I decided to stop messing about with QRisk3.

 

[DaveB]

Personally I have no faith in the QRisk algorithm. If you include diabetes it's almost guaranteed to say you need statins. Not very scientific.

 

[bulkbiker]

We discussed my cholesterol level which hasnt reduced since the previous test (7.4

Had you water only fasted before the test and how long for?
Did you get a full lipid panel or just the total cholesterol number?

 

[AndBreathe]

Like so many outputs of these little gizmos, it is dependent on the inputs.

Despite being in remission since 2014, and having a clear bill of cardiac health last year, my GP is keen to input T2 to the system, and tell me that even if my QRisk score was lower, statins are great things, and do I know that people in other countries can't understand why we use them so little in UK. He loves his statins he takes every day.

I left, happily in the knowledge there was one more dose for him if wanted them.

The statins "discussion" is so mired in prejudice, questionable theories and BIG advertising.

 

[Felinia]

20 years ago I lost 4.5 stone and my cholesterol went up! I was not diabetic then. I was told then it was due to the function of my liver. Don't know what the current thinking is.

 

[harbottle]

20 years ago I lost 4.5 stone and my cholesterol went up! I was not diabetic then. I was told then it was due to the function of my liver. Don't know what the current thinking is.

Rapid weight loss does cause a rise in cholesterol, but it's only temporary. It's a well documented side effect. The same happened to me, even though my diet was well below the recommended limits for saturated fat.

It all went back to normal once weight had stabilised.

GPs don't seem to know this - mine certainly didn't and was quite surprised when I mentioned it.

When it went up I refused statins as I'd read some of this research and was confident it would come down (It did.)

 

[Jenny65]

Had you water only fasted before the test and how long for?
Did you get a full lipid panel or just the total cholesterol number?

Hi I had fasted for 16 hours before the test and it included LDL and HDL but not Triglycerides. so I am having another one, the doctor was unsure why I didnt have the full tests. He seems to be of the thought process similar to mine that I could give diet a little longer and at least for another 3 months to see what the Lipid Clinic suggest 🙂

 

[Jenny65]

I have low blood pressure, healthy BMI, no relatives with heart issues, my BG is under control and I dont smoke, so he is of the mind set it is literally just the cholesterol to get on top of. I am just worried that I could work to get it under control myself and will be disappointed in myself if I dont give it another shot, its a personal choice and I have respect that statins may be needed to help in the end, but I am not good with medication. I had my gall bladder removed in my thirties and often get pain from certain meds, which only later was I told it could be due to Sphincter of Odi, I cant tolerate codeine, betablockers, morphine, or antihistamines and a few others, the pain I get afterwards is unbelievable.

 

[nonethewiser]

He kept saying how he found it odd that all my results were identical to the last test, he almost hinted it was an error, I do wonder bearing in mind my very first blood test came back that I didn't have diabetes when I in fact very much did!

Agree with sensible advice of others to ask for repeat test of your cholesterol, only then can you decide which avenue to take to lower it if result is as high as before.

 

[Burylancs]

Hi all

I had my follow up appointment with my GP to discuss my blood test results. We discussed my cholesterol level which hasnt reduced since the previous test (7.4) He found it odd as it was clear my weight loss and BG was going down. He did my QRISK assessment which he looked at my age, my weight, BMI, blood pressure, BG level, and my cholesterol, plus there being no family history of cardiac issues and it came back as 5, he said anything 10 or over and he would advise statins but at 5 its pretty low and he is happy with my keeping on with my diet and monitoring.

I was pleasantly surprised as thought he would try and persuade me to have medication. The things in my favour he said were my low blood pressure, being in remission and having no family history of heart problems. He said he did it again and listed me as diabetic and it came back as 11 but he said if I keep my BG the same or lower he thinks I am low risk.

This is the first time I have heard of this test but thought I would share as they did take all factors into consideration to ensure I am treated apporpriately. He is referring me for a bone density scan and another follow up blood test in 3 months.

I thought the Nice advice was to call in all the blood relatives of someone over 7.2 Total Chols for testing for Familial Hypercholesterolenemia (?), FH a killer of middle aged people. Quite amazing that the Doc didn't enter you as 'disbetic' first time round, he couldn't have got a proper Qrisk score result without it so you can probably discount the 5 and run with the 11.

Under 4 for Total Chols is the traditional recommendation for Chols in Diabetics after Edwin Biermann's research in the 1990s. And the LDL levels are back in importance now, and 'ratios' out of fashion.

 

[Leadinglights]

I thought the Nice advice was to call in all the blood relatives of someone over 7.2 Total Chols for testing for Familial Hypercholesterolenemia (?), FH a killer of middle aged people. Quite amazing that the Doc didn't enter you as 'disbetic' first time round, he couldn't have got a proper Qrisk score result without it so you can probably discount the 5 and run with the 11.

Under 4 for Total Chols is the traditional recommendation for Chols in Diabetics after Edwin Biermann's research in the 1990s. And the LDL levels are back in importance now, and 'ratios' out of fashion.

Somebody I knew at work, was concerned that her children would have Hypercholesterolenemia as her husband had and his family did so they had genetic testing done.
It looks as if there may be a new drug that is better than statins to treat it.

 

[Burylancs]

It might be unprofessional to leave a Total Chols of 7.4 untreated, diabetes or not.

 

[harbottle]

B

Somebody I knew at work, was concerned that her children would have Hypercholesterolenemia as her husband had and his family did so they had genetic testing done.
It looks as if there may be a new drug that is better than statins to treat it.

My niece has it. Her aunt died in her 30s of a sudden heart attack, so both her and her sister were tested for it - their Dad's side of the family has a history of people dying young from heart problems. One had it, one didn't. Her uncle has it as well. She's now on statins.

 

[42istheanswer]

I thought the Nice advice was to call in all the blood relatives of someone over 7.2 Total Chols for testing for Familial Hypercholesterolenemia (?), FH a killer of middle aged people. Quite amazing that the Doc didn't enter you as 'disbetic' first time round, he couldn't have got a proper Qrisk score result without it so you can probably discount the 5 and run with the 11.

Under 4 for Total Chols is the traditional recommendation for Chols in Diabetics after Edwin Biermann's research in the 1990s. And the LDL levels are back in importance now, and 'ratios' out of fashion.

If I recall correctly from her previous threads, @Jenny65 is waiting for lipid clinic to be tested for Familial Hypercholesterolemia. It would seem to make sense for her to tested for that before testing her children for it.

 

[bulkbiker]

And the LDL levels are back in importance now, and 'ratios' out of fashion.

With whom?

LDL is not even considered in the QRisk3 calculation and is usually calculated not measured so...