Statins 'could benefit the healthy'

 

Cholesterol-lowering drugs can benefit even apparently healthy people with no previous history of heart disease, a study has found.

The findings suggest everyone over a certain age should qualify for statin therapy, say experts.

Many doctors already take the pills, which lower levels of cholesterol in the blood.

But NHS prescriptions of the drugs are restricted to patients judged to have at least a 20 per cent risk of a "major vascular event" in the next 10 years.

A major vascular event can include a non-fatal heart attack, stroke, or surgery to bypass or unblock damaged arteries.

The authors of the new research say the findings suggest international treatment guidelines for statins should be reconsidered.

To conduct the "meta-analysis" study, they pooled together data on 175,000 patients who took part in 27 separate randomised trials.

Participants were grouped into one of five categories of five-year major vascular event risk.

Statins were found to reduce the risk of serious vascular events by more than a fifth (21 per cent) for each unit reduction in levels of harmful cholesterol.

The pattern was repeated in each of the five groups studied, including those people at lowest risk.

In individuals where the five-year chance of a major event was less than 10 per cent, the already small risk was significantly lowered, even in people with no history of vascular disease.

This was mainly due to reduced numbers of heart attacks and surgical operations.

The findings appear in the latest online edition of The Lancet medical journal.

Researchers measured millimoles per litre (mmol/L) reductions of "bad" low density lipoprotein (LDL) cholesterol in the blood.

They found that every one mmol/L lowering of LDL cholesterol reduced the risk of major vascular events by 21 per cent "irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular and all-cause mortality".

In people with a five-year risk of major vascular events lower than 10 per cent, each unit lowering of LDL cholesterol reduced event incidence by about 11 per 1,000 individuals over five years.

The authors, led by Professor Colin Baigent, from Oxford University, wrote: "This benefit greatly exceeds any known hazards of statin therapy.

"Under present guidelines, such individuals would not typically be regarded as suitable for LDL-lowering statin therapy. The present report suggests, therefore, that these guidelines might need to be reconsidered."

The research found no evidence that statins increased cancer incidence or deaths from non-vascular causes.

In an accompanying article, two UK experts said more affordable ways of identifying patients suitable for statins were needed.

Professor Shah Ebrahim and Dr Juan Casas, both from the London School of Hygiene and Tropical Medicine, wrote: "Because most people older than 50 years are likely to be at a greater than 10 per cent 10-year risk of CVD (cardio-vascular disease), it would be more pragmatic to use age as the only indicator of statin prescription.

"This approach would avoid the costs, ranging from £7 to more than £700 per patient screened, of vascular screening checks recently implemented in the UK."

June Davison, senior cardiac nurse at the British Heart Foundation, which part-funded the study, said: "Those who already have heart disease, or are at high risk, are offered statins because it's well established they help to lower cholesterol and reduce the risk of heart disease.

"This large-scale research found even people at low risk of heart disease could benefit from statin therapy. The findings will help to inform policy and treatment guidelines in the future."

Other research published in The Lancet challenges the widely-held view that raising levels of "good" cholesterol can reduce the risk of heart attacks.

Scientists looked at heart attack rates in people with naturally higher levels of high-density lipoprotein (HDL) cholesterol.

Analysis of data from 20 studies involving more than 100,000 people found no evidence that elevated HDL reduced the chances of having a heart attack.

Lead author Dr Sekar Kathiresan, from Harvard Medical School in the US, said: "If an intervention such as a drug raises HDL cholesterol, we cannot automatically assume that risk of myocardial infarction (heart attack) will be reduced."

A Department of Health spokesman said: "We keep all new research under consideration. Nice (National Institute for health and Clinical Excellence, which assesses the cost effectiveness of NHS treatments) regularly reviews its published guidance in order to take account of new evidence."

PA

News
peoplePaper attempts to defend itself
Voices
voicesWe desperately need men to be feminists too
Life and Style
food + drink
Arts and Entertainment
British actor Idris Elba is also a DJ and rapper who played Ibiza last summer
film
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Account Executive/Sales Consultant – Permanent – Hertfordshire - £16-£20k

    £16500 - £20000 Per Annum: Clearwater People Solutions Ltd: We are currently r...

    KS2 PPA Teacher needed (Mat Cover)- Worthing!

    £100 - £125 per day: Randstad Education Crawley: KS2 PPA Teacher currently nee...

    IT Systems Manager

    £40000 - £45000 per annum + pension, healthcare,25 days: Ashdown Group: An est...

    IT Application Support Engineer - Immediate Start

    £28000 per annum: Ashdown Group: IT Software Application Support Analyst - Imm...

    Day In a Page

    Syria air strikes: ‘Peace President’ Obama had to take stronger action against Isis after beheadings

    Robert Fisk on Syria air strikes

    ‘Peace President’ Obama had to take stronger action against Isis after beheadings
    Will Lindsay Lohan's West End debut be a turnaround moment for her career?

    Lindsay Lohan's West End debut

    Will this be a turnaround moment for her career?
    'The Crocodile Under the Bed': Judith Kerr's follow-up to 'The Tiger Who Came to Tea'

    The follow-up to 'The Tiger Who Came to Tea'

    Judith Kerr on what inspired her latest animal intruder - 'The Crocodile Under the Bed' - which has taken 46 years to get into print
    BBC Television Centre: A nostalgic wander through the sets, studios and ghosts of programmes past

    BBC Television Centre

    A nostalgic wander through the sets, studios and ghosts of programmes past
    Secret politics of the weekly shop

    The politics of the weekly shop

    New app reveals political leanings of food companies
    Beam me up, Scottie!

    Beam me up, Scottie!

    Celebrity Trekkies from Alex Salmond to Barack Obama
    Beware Wet Paint: The ICA's latest ambitious exhibition

    Beware Wet Paint

    The ICA's latest ambitious exhibition
    Pink Floyd have produced some of rock's greatest ever album covers

    Pink Floyd have produced some of rock's greatest ever album covers

    Can 'The Endless River' carry on the tradition?
    Sanctuary for the suicidal

    Sanctuary for the suicidal

    One mother's story of how London charity Maytree helped her son with his depression
    A roller-coaster tale from the 'voice of a generation'

    Not That Kind of Girl:

    A roller-coaster tale from 'voice of a generation' Lena Dunham
    London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

    London is not bedlam or a cradle of vice

    In fact it, as much as anywhere, deserves independence
    Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

    Vivienne Westwood 'didn’t want' relationship with McLaren

    Designer 'felt pressured' into going out with Sex Pistols manager
    Jourdan Dunn: Model mother

    Model mother

    Jordan Dunn became one of the best-paid models in the world
    Apple still coolest brand – despite U2 PR disaster

    Apple still the coolest brand

    Despite PR disaster of free U2 album
    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum