Abstract
Mrs Potts, 72, is seeing the practice nurse weekly to have a chronic venous ulcer dressed. The nurse arranged some blood tests for Mrs Potts. The HbA1c and renal function are normal, but the cholesterol is elevated, so Mrs Potts makes an appointment to see you.
You review her record: She has no history of cardiovascular disease, she is a non-smoker and has no family history of cardiovascular disease. Her blood pressure is 122/78, BMI 24.5 and her lipid profile is as follows:
Total cholesterol 7.2 mmol/L Low-density-lipoprotein (LDL) 6.3 mmol/L High-density-lipoprotein (HDL) 1.12 mmol/L Cholesterol/HDL ratio 6.4
Mrs Potts is cross that her cholesterol was checked without her knowing. She is worried sick about her heart, and has heard that statins cause all sorts of side effects.
‘I want to know exactly what my risks are, and don’t you dare bully me into taking a statin’, she says as she walks into the room.
How would you approach this consultation? What benefit might she get from a statin? What are the risks? Should the nurse have asked consent before requesting a lipid profile? Do you always get consent for this test?