News
Aggressive cholesterol-lowering improves heart outcomes
Using cholesterol-lowering medications more intensively to achieve a more aggressive target for low-density lipoprotein cholesterol (LDL-C) reduced the rate of major cardiovascular events by one-third among patients with atherosclerotic cardiovascular disease (ASCVD), according to a study presented at the American College of Cardiology’s Annual Scientific Session (ACC.26). The results help fill an evidence gap in guiding
treatment for patients with heart disease who face a high risk of serious cardiac events. Although guidelines have lowered the recommended LDL-C target for patients with ASCVD from less than 70 mg/dL to less than 55 mg/dL, the evidence supporting this recommendation has been limited. The new trial, called Ez-PAVE, is the first randomised, head-to-head comparison of these two LDL-C targets in patients with ASCVD.
“The Ez-PAVE trial adds practical and clinically meaningful evidence by demonstrating that, in patients with ASCVD, targeting an LDL-C level of less than 55 mg/dL leads to a significantly lower three- year risk of major cardiovascular events compared with the conventional target of 70 mg/dL, without compromising safety,” said Byeong-Keuk Kim, MD, director of the Cardiac Catheterisation and Intervention Department and professor in the Division of Cardiology at Severance Hospital, Yonsei University College of Medicine in Seoul, South Korea, and the study’s lead author. ASCVD is a type of heart disease in which plaque accumulates in artery walls. LDL-C contributes to plaque buildup. Therapies that reduce LDL-C can help slow the buildup of plaque in the artery walls and reduce the likelihood that plaques will rupture and cause serious events such as heart attacks and strokes. However, most previous studies have focused on assessing outcomes from various LDL-C lowering therapies rather than assessing the optimal LDL-C level to target with these therapies. “The benefit of targeting LDL-C lower than 55 mg/
dL is broadly applicable across the spectrum of patients with ASCVD and is not limited to specific patient subsets,” Kim said, noting that the findings are especially relevant for patients in higher-risk categories, for whom lower LDL-C targets are currently recommended.
Consultation on guidance for doctors and personal beliefs
A consultation on updated guidance detailing how doctors can practice in line with their beliefs and values, while maintaining good and safe care of their patients, has been launched by the General Medical Council (GMC). The regulator is seeking views on draft
updates to its Personal beliefs and medical practice guidance, which will be applicable to all doctors, physician associates (PAs) and anaesthesia associates (AAs) working in the UK. GMC guidance is designed to support
registrants to provide good and safe care, and is reviewed periodically. This is the first significant update to this guidance since 2013, and is intended to reflect legal, social and cultural changes in the years since. Personal beliefs can cover religious, moral or ethical concerns that might influence the way doctors, PAs and AAs practice. An example could be a conscientious objection to providing certain treatment or procedures. If doctors, PAs or AAs do have a conscientious objection, the proposed guidance makes clear the patient must be prioritised, and that such an objection must not prevent someone being able to access the care or service they need. The consultation runs until 11 June. Visit:
https://tinyurl.com/4dcwt4a9
New report considers the future of ‘the patient’s voice’
A new report from The King’s Fund has been published, which looks at the need for a patient voice that is independent of government and services, while examining what can be learned from the Healthwatch model, in the wake of its abolition in June 2025. Since 2013, Healthwatch has operated nationally and locally to gather the views of people using the health and care system in England. Its primary role has been to support improvements to services by reporting people’s experiences, which it has done by working with communities across England, collecting feedback on health and care services, and sharing this information with government bodies and local systems to inform policy and service development. On 27 June 2025, the government announced plans to close Healthwatch England and the network of 153 local Healthwatch organisations. In line with recommendations from the Dash review of patient safety, the government plans to transfer the strategic functions of Healthwatch England to the Department of Health
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and Social Care (DHSC), and the statutory functions of local Healthwatch organisations to NHS integrated care boards (ICBs) on health care and local authorities for views on adult social care. In light of these planned changes, the King’s
Fund research explored what can be learned from the Healthwatch model, including what has worked well, what the challenges have been and how this can inform the government’s planned changes to how patient and service user experiences are collected and used. The King’s Fund reviewed existing evidence, conducted interviews and carried out two workshops with local and national stakeholders. The final report, ‘The future of patient voice: learning from the Healthwatch model ’, outlines the following findings: l Healthwatch’s independence has ensured it’s been seen as credible by communities and allowed scrutiny of issues the health and care system may overlook.
l Strong local relationships – especially with people less likely to engage with statutory
bodies and those affected by health inequalities – were key to the model’s strength. Healthwatch has collected significant volumes of qualitative and quantitative data since it was first set up, helping the health and care system capture emerging issues that matter to patients, service users, and local communities. The organisation’s limited statutory powers mean it can report on issues but cannot hold the health and care system to account for addressing them. The King’s Fund’s view is that whatever replaces
Healthwatch must build on the core conditions that enabled it to have a positive impact: a voice independent of government and services; the capacity to gather unsolicited, varied and rich community insight, including from seldom heard groups; and a geographical scale that supports both local insight and system or national-level influence. It concludes that any future model must enhance – not weaken – the system’s capacity to hear, understand and respond to people’s experiences. Visit:
https://tinyurl.com/hcfpy77u
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