Statins for everybody over 50?Comment on this story
London - All over-50s should take statins to cut their risk of suffering a heart attack or stroke, researchers claim.
A major study shows the drugs – usually only given to high-risk patients – provided clear benefits among healthy ones too.
Researchers reviewed findings from 27 trials involving 175,000 people, some of whom were at low risk of heart problems. They found that the positives greatly exceeded any side-effects, such as muscle weakness, diabetes and depression.
More than eight million adults are already taking statins, with some experts predicting that one in four will soon be taking the drugs for life.
Borislava Mihaylova of the University of Oxford, lead author of the study, said: “In the UK, current practice is generally to give people a statin only if they have had or are considered to be at “high risk” of having a heart attack or a stroke. This study shows that the benefits of statins extend to a much lower-risk group of people than previously thought.”
The research, co-ordinated by Oxford and the University of Sydney in Australia, looked at more than two dozen studies using statins to cut levels of low-density lipoprotein or ‘bad’ cholesterol in the blood. The drugs cut the risk of heart attacks, strokes and operations to unblock arteries by one third or more.
The benefits were gained no matter what level of cholesterol patients started out with. Healthier people who were given statins also had lower overall death rates than those who were given a placebo.
The study, published online by the Lancet, was funded by the British and Australian medical research councils and the British Heart Foundation. Its authors say the imminent revision of NHS guidelines on the use of statins should be used to widen those eligibile for routine therapy. At present, statins are restricted to those with at least a 20 percent risk of having a heart attack or stroke over the next ten years.
However, a commentary in the Lancet says most over-50s are likely to be at higher risk of cardiovascular disease, and so it would be “pragmatic” to use age to prescribe statins instead of costly medical tests.
Professor Colin Baigent, from the Medical Research Council, said: “It is not just about treating raised cholesterol after middle-age. The benefits of statins in people who are currently healthy, but are for some reason at increased risk of a heart attack or stroke, are substantial, and much greater than any of the known risks.
“People who are at increased risk, perhaps because they are overweight, or smoke, or have high blood pressure, would be better off with lower cholesterol, even if their cholesterol is not considered to be particularly high.”
Professor Baigent believes the routine use of statins would lead to 10,000 fewer heart attacks and strokes a year, including 2,000 fewer deaths in the UK. The small cost of the drugs would be outweighed by NHS savings due to the reduced number of heart attacks and strokes.
June Davison of the British Heart Foundation 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.”
The report does warn that patients may be at a slightly higher risk of diabetes, but adds that “the definite benefits of statins greatly outweigh these potential hazards”.
A Department of Health spokesman said: “We keep all new research under consideration. NICE [the 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.” - Daily Mail