healthmedicinet

• Statins were prescribed to those who had 30% risk or more of heart attack
  
• Threshold was lowered in 2005 to include patients with 20% risk or more of a heart attack within a decade
  
• New rules have now decreased the risk level again to 10% – making the drug available for millions more patients
  
• Up to seven million Britons are already on statins at annual cost of £450m
  

By
Jenny Hope

PUBLISHED:

19:51 EST, 11 February 2014

|
UPDATED:

03:25 EST, 12 February 2014

New rules: Millions more Britons will be eligible to take statins after new rules lowered the criteria to a 10% risk or more of having a heart attack in a 10 year period

Millions more patients will be offered statins to cut heart attacks and strokes under new NHS guidelines.

Doctors used to prescribe the drugs only to those who had a 30 per cent or greater risk of suffering a heart attack within a decade.

This was lowered to a 20 per cent risk in 2005, but now medics could be handing pills to those with just a 10 per cent risk.

The new rules would make at least 10million patients eligible for anti-cholesterol drugs, securing Britain’s place as the statins capital of Europe.

However, some doctors are concerned, claiming the plan will unnecessarily ‘medicalise’ many healthy people, exposing thousands to harmful side effects while making only a minimal difference to the number of heart attacks and strokes.

As many as seven million people in the UK are on statins, at an estimated annual cost of £450million.

Draft proposals from the National Institute for Health and Care Excellence (Nice) would see the drugs offered to anyone with a 10 per cent or greater ten-year risk. Even patients aged 80 and over are likely to get them despite little evidence they will benefit.

Guidelines are being re-written partly because of the low price of statins which cost a few pence a day. Low-dose statins cost around £1 a month per patient.

Nice says the draft guidance will make clear doctors should first work with patients to cut lifestyle factors putting them at risk, such as stopping smoking, drinking less, taking exercise and eating a healthy diet.

High intensity statin therapy, with a drug such as atorvastatin, should be offered to patients once these factors have been addressed, it says.

But an analysis by the British Medical Journal suggested 140 patients would have to take them to prevent one heart attack or stroke in a man.

London cardiologist Dr Aseem Malhotra said there was limited evidence for wholescale prescribing of statins to relatively healthy people, and even less evidence that they were effective for women.

Alternative: But the draft proposals say doctors should work with patients to cut lifestyle factors putting them at risk – getting people to cut down on drinking alcohol and to do more exercise

He said ‘real world’ data and his own experience suggested one in five patients suffered side effects including muscle aches, memory loss and erectile dysfunction in men – with many patients giving up on taking the drugs as a result.

He said patients targeted by the new advice had more to gain from lifestyle changes because drugs could threaten their quality of life, especially people in their 80s. 

Dr Malhotra said: ‘Just because it’s
cheap doesn’t mean it’s risk free. This is going to benefit the
pharmaceutical industry more than patients.

THE CHOLESTEROL BUSTER… WITH SIDE EFFECTS

More than one million prescriptions for statins are written each week in England, compared with a few thousand in 1981

The drugs reduce blood levels of cholesterol, the waxy fat-like substance which can build up inside arteries, raising the risk of heart disease and stroke

They block an enzyme involved in the production of ‘bad’ cholesterol, especially in the liver

Studies suggest statins may protect against other health problems, including eye disorders and Alzheimer’s, by maintaining a healthy supply of blood to the brain

The most serious side effect is myopathy, resulting in muscle pain and weakness. Others include cataracts, headaches, loss of appetite and pain in nerve endings

There is controversy over whether women get the same benefits from statins as men, because few women were included in trials – most patients were white, middle-aged men

‘There is no doubt that people with established heart disease get more benefits than harm from statins.

‘But this plan is not a good idea because we’ll be medicalising many relatively healthy patients.’

Other medics said the benefits of statins far outweighed any side effects.

Rory Collins, professor of medicine at Oxford University, worked on a study published in The Lancet which found the benefits of statins greatly exceed any side effects such as muscle weakness, diabetes and depression.

He said the number who could begin taking statins as a result of the new Nice guidance could be as many as five million, as predicted in 2012 by the team.

Prof Collins believes there has been too much attention paid to side effects, with trial data showing only one significant problem, myopathy or muscle pain, which affects one in 10,000 patients.

He said ‘People say you are medicalising the population by recommending statin use at these lower levels. That’s complete nonsense. This remains a choice for the patient, it’s not mandatory.’

Cardiovascular disease is the leading cause of death in England and Wales – it caused one in three of all deaths in 2010, around 180,000. The NHS estimates statins save 7,000 lives a year.

The latest proposed cut follows a recent change in US policy, which suggested the threshold for statins should be set as low as 7.5 per cent risk of heart disease in ten years.

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Comments (63)

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The comments below have been moderated in advance.

Jane,

Lancashire,

1 hour ago

I read a novel once about overpopulation in what had become a United States of Europe with a President at the head. They had devised a plot to pretend to inoculate people against a disease, in reality they were culling the population …..wish I could remember the name of the book. I sometimes wonder just how far fetched this will actually prove to be in the future.

Cassandra,

Paphos,

1 hour ago

A study has shown that the side effects of statins can be far worse than previously thought, the study suggests. for the first time, the level of harm posed by the cholesterol-lowering drugs has been quantified by researchers. They found some users are much more likely to suffer liver dysfunction, acute kidney failure, cataracts and muscle damage known as myopathy. For Black patients, the risk is eight times higher than among those not taking statins. Overall, the risk of myopathy – which may be irreversible – is six times higher for men on statins and three times higher for women.
I am not advocating whether you take statins or not, just be aware of the mountain of information available for you to make an informed judgement. After suffering leg cramps etc, I stopped taking them and now take no medical drugs designed to prevent a condition. Would you take a paracetamol each day to prevent you developed a headache?

Elle,

Bournemouth,

1 hour ago

The Cholestrol hypothesis was based on faulty and biased research. There is little real evidence that statins have cut cardiac disease in 20 years. Any decline in numbers is far more due to the lack of smoking ! Research the evidence….

Big Blue,

Manchrster,

1 hour ago

For people who have NOT had a previous heart attack the use of statins does absolutely nothing to prolong life. That is the bare, simple fact. Whoever, even the GPs who don’t believe in them are reluctant to go against the advice of the experts for fear of being sued later down the line and because they would miss out on the bonuses the Government give them for putting yet more of us on the things.

marion,

stowmarket,

1 hour ago

Wont take them!

charles10,

watford,

1 hour ago

Neither doctors or politicians are worthy of trust. Mass poisoning to keep population under control.

chas,

Nr Tenby,

1 hour ago

My Docs been pushing them but I refused after looking up the side effects research from around the world , the latest shows manufactured SUGAR to be at the back of the body probs. I eat an egg a day, use butter all natural products .Cholesterol ? 5.5

EggLover,

Shropshire, United Kingdom,

1 hour ago

Before you swallow ONE Statin pill read “The Great Cholesterol Con” by Dr Malcolm Kendrick. Unless you’ve had a heart attack or have heart disease you need to seriously think about the advice you’re given by your GP.

lavenderpicker,

DownSouth, United Kingdom,

1 hour ago

I was put on statins and within 24hours I could hardly move with the pain and swelling in my joints. I was in agony. Never again. Acute allergy to the drug. Doc says try another brand but I’m not prepared to put my self through the agony. If one refuses it goes down as not having listened to advice. My advice is to accept the prescription but not take the drug. No one is the wiser. Shame because it’s a waste of money. But I don’t like the lectures that go with refusing what I’m told is good for me. Why don’t they prescribe exercise classes, gyms and classes are too expensive for some of us. A daily walk is what I do but would love to join a group for more vigorous exercise but can’t afford it. If the doc prescribed it in the long run the NHS would save money.

the geek,

uk,

1 hour ago

you are the boss, just say no and then get up and leave

smith99,

Stourbridge, United Kingdom,

1 hour ago

The research is being paid for by big pharma so is tainted. New research is coming out saying how harmful stations are, they kill your body’s coq10 which is a very bad thing. Cholesterol IS NOT BAD for you, free radicals in processed food is the evil, and yet as the food companies donate to political parties no one touches them. Watch station nation documentary for more info.
Stations have been around several decades now and yet you won’t live any longer for taking them.

the geek,

uk,

1 hour ago

and coQ10 is essential and very expensive

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