Statins: should millions more be taking cholesterol drug?

Doctors cast doubt on Nice proposal to prescribe drug for more healthy people in a bid to cut deaths

LAST UPDATED AT 12:54 ON Wed 12 Feb 2014

MILLIONS more people should be put on statins to protect them against heart attacks and strokes, according to draft guidelines for the NHS in England. The National Institute for Health and Care Excellence (Nice) has proposed halving the risk threshold for the drugs, meaning that the vast majority of men aged over 50 and women aged over 60 would be put on the treatment.

So what exactly are statins?

They are a group of medicines that can help lower rates of "bad cholesterol" in the blood by curbing the production of low-density lipoprotein cholesterol inside the liver. A high rate of this type of cholesterol is believed to be potentially dangerous as it can lead to the hardening and narrowing of arteries, which increases the risk of strokes and heart attacks.

Who takes statins now?

Doctors are currently supposed to offer statins to people who have a 20 per cent chance of developing heart disease. This accounts for around seven million people. The risk is calculated using factors such as age, sex, weight and whether or not a person smokes.

What do the draft guidelines say?

Nice now suggests that people with a ten per cent risk should be offered statins. The number of people taking the drug would therefore increase to around 12 million, says the Daily Telegraph. Cardiovascular disease is the leading UK killer, claiming around 180,000 lives a year. The NHS estimates statins save 7,000 lives a year, so by widening the scope for offering the drug, Nice hopes to save more lives. The proposal, which will go out to public consultation, follows new US guidelines that say anyone with a 7.5 per cent risk should be considered for the drugs.

How much would it cost?

The NHS currently spends around £450m a year on statins. If the draft recommendations get the go ahead, this bill will increase substantially. However, the drugs have become significantly cheaper to buy over the years.

What are the downsides?

The benefits of statins for healthy people has long been disputed by experts. Potential side effects include problems with muscles, liver and kidneys, cataracts, type 2 diabetes, memory loss and sleep disturbance. Dr Kailash Chand, a former GP, told the BBC that statins should be used "judiciously where they are needed but not for healthy people". He added that 80 per cent of the risk of heart disease comes from factors such as smoking, lack of exercise and an unhealthy diet, and warned that statins might give people false assurances that they can continue with an unhealthy lifestyle.

The British Medical Journal has also cautioned against any expansion in prescribing and points out that much of the research on statins used by Nice is funded by drug companies. One study published in the BMJ in December found that eating an apple a day could help cut the risk of heart disease as effectively as taking a statin tablet a day. · 

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Statins: should millions more be taking cholesterol drug? I
advise caution. Playing around with cholesterol is dangerous. Dietary control is better.

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