12 million Brits will be advised to take Statins
Statins: 12 million Brits will be advised to take cholesterol-lowering drug - Telegraph
From The Telegraph
London, UK
11 February, 2014
Statins: 12 million Brits will be advised to take cholesterol-lowering drug
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"Britain is already the “statins capital” of Europe - with the second highest prescribing levels in the Western world, amid spiralling obesity and aggressive prescribing of the medication by GPs, whose pay is linked to take-up of the pills"
Twelve million people will be told to take statins under controversial new NHS guidelines.
Draft proposals from health watchdogs mean the vast majority of men aged over 50 and most women over the age of 60 are likely to be advised to take the drugs to guard against strokes and heart disease.
The National Institute for Health and Care Excellence (Nice) has cut the “risk threshold” for such drugs in half - meaning that millions more patients with a relatively low risk of heart disease will in future be urged to take cholesterol-lowering drugs.
Experts said the changes mean the number of patients advised to take the drugs is likely to rise from seven million to 12 million, leaving one in four adults on the medication.
Current medical guidance says anyone with a 20 per cent risk of developing cardiovascular disease within 10 years should be offered statins.
Under the proposed changes, those with a 10 per cent risk of such disease within a decade will be advised by their GP to take the drugs.
Experts said this will mean that the vast majority of men in their 50s, and most women over 60, will meet the risk threshold.
Britain is already the “statins capital” of Europe - with the second highest prescribing levels in the Western world, amid spiralling obesity and aggressive prescribing of the medication by GPs, whose pay is linked to take-up of the pills.
The drugs are the most commonly prescribed medication in Britain, costing the NHS £450 million a year.
Studies suggest that 83 per cent of men aged 50 and 56 per cent of women aged 60 will meet the new risk threshold, which is calculated by assessing factors including age, cholesterol levels, blood pressure and weight.
Dr David Wald, a cardiologist at Queen Mary, University of London, said that it would be better to scrap the complex assessments proposed, and instead simply hand out pills on the basis of age.
He said: “The guidelines are too complicated. It would be simpler and less costly to offer preventive treatment once a person has reached a certain age - say age 50 or 55 - since almost all heart attacks and strokes occur over 50.”
Shah Ebrahim, professor of public health at the London School of Economics, said the recommendations were necessary - but a sad indictment of modern lifestyles in this country.
He said: “It is a concern to have to mass medicalise the whole of the British public in this way. A lot of this is about the food we eat - the saturated fat and processed foods and about the failure to control the food industry. In the long term, we need to move way from the idea that 'drugs for everybody’ is the way to tackle this problem,” he said.
In October, an analysis in the British Medical Journal cautioned against any expansion in prescribing.
One of its authors, Dr John D Abramson, clinical lecturer in primary care, from Harvard Medical School, last night said: “I think we have become victims of the drug companies. All the research is funded by them, and the really important message - that reducing your risk of heart disease is best done by an improved diet and lifestyle - is getting crowded out.”
Professor Sir Rory Collins, Professor of Medicine and Epidemiology at the University of Oxford, said: “The evidence supports the recommendations - the drugs are effective, they prevent cardiovascular events even in low-risk groups, and they are very well tolerated. There might be people who don’t like the idea of mass medication but the NHS recognises that it is cost-effective,”
Studies have suggested that up to one in five patients taking statins suffers some kind of ill-effect, including muscle aches, memory disturbance, cataracts and diabetes.
Sir Rory said many of the claims made about such side-effects had been refuted, or found to only be suffered by low numbers of patients, and outweighed by the benefits from the drugs, which cost around 10 pence per patient per day.
The Nice guidance also says GPs need to do much more to identify patients aged between 40 and 74 who may be at risk of heart disease, which is the leading cause of death in the UK, responsible for one in three deaths.
The proposals, which will go out to public consultation, follow new US guidelines which say that anyone with a 7.5 per cent chance of heart disease over 10 years should be considered for the drugs.
Statins: what does it mean for me?
Under the proposed changes, GPs will be told to advise anyone with a 10 per cent chance of developing heart disease in the next decade to take statins.
Calculations are made by assessing age, cholesterol levels, blood pressure, weight, and any health conditions.
Experts say that because age increases the risks of disease sharply, most men aged 50 and women aged 60 will be advised to take the drugs.
Age alone does not mean such patients would be prescribed the drugs, but as patients get older the chance of other factors that raise their risks - such as high blood pressure, high cholestoral and excess weight - also increase.
Who meets the 10 per cent threshold?
* Man aged 59, non-smoker, healthy weight, healthy blood pressure and healthy cholesterol level
* Woman aged 65, non-smoker, healthy weight, healthy blood pressure and healthy cholesterol level
* Man aged 40, overweight, moderate smoker, healthy blood pressure, slightly raised cholesteroral level
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