Prescribing more statins could save lives
Wednesday 28 May 2008
More than one million adults at high risk of a heart attack or stroke are missing out on treatment that could save their lives, experts said yesterday.
GPs are failing to identify those at risk because patients are not routinely assessed and offered advice on changing their lifestyle or treatment with drugs, the National Institute for Clinical Excellence (Nice) said.
An estimated 4.1 million people currently take statins to reduce cholesterol, but another 1.4 million should be offered them, which could save an extra 15,000 heart attacks and strokes each year, the institute said.
Statins have been described as the miracle drugs of the 21st century, with the capacity to cut the risk of heart attacks and strokes by a third. They reduce the level of cholesterol in the blood, which can cause blockages in the arteries. In 2005, cardiovascular disease caused 124,000 deaths, one in three of all mortalities in the UK.
New guidelines issued by Nice yesterday say all adults aged 40 to 75 should be assessed for risks, including smoking, weight and blood pressure and those with at least a 20 per cent increased chance of a heart attack over the next 10 years should be offered treatment.
Gillian Leng, deputy chief executive of Nice, said: "This guideline has huge potential to reduce preventable events [heart attacks and strokes]. The point is to provide a systematic targeted approach. In the past the patients who have been the focus of treatment are those who have already had a heart attack. This looks at people at high risk before they have had a heart attack, to prevent it happening. We should be able to prevent 15,000 heart attacks and strokes each year."
No one would be forced to have drug treatment, but people at high risk should be told and given advice, she said. However, reducing cholesterol by diet alone – eating less fat and more fruit and vegetables – is hard to achieve, while taking a statin is simple, easy and effective.
Last year, Professor Roger Boyle, the Government's heart tsar, suggested every man over 50 and woman over 60 could be offered a daily statin to reduce their heart attack risk.
The benefits of mass medication had to be balanced against financial and medical costs, Dr Leng said. The Nice recommendations were estimated to cost £28m in the first year, much less than giving statins to all in middle age. "There is evidence that the lower the cholesterol the greater the benefit. But there is a trade off in costs and side effects. We considered the benefits best accrued in those with a 20 per cent or greater risk."
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