The statins shambles

Millions on tablets risk heart attack because cholesterol’s still too high

HALF of statins patients are failing to control their cholesterol with the tablets alone – putting millions at risk of heart attacks and strokes.

Scientists said doctors should be prescribing statins in combination with modern injectable drugs that can dramatically improve the problem.

These treatments – called PCSK9inhibitors – have been available on the NHS since 2016.

But a study suggests only 1 per cent of patients are using them.

Even effective non-statin tablets, such as ezetimibe, are under-used with the take-up only 9 per cent. Scientists believe this is partly because guidelines by NHS watchdog NICE are dated and do not recommend a low enough cholesterol target.

It means millions of patients could be living with dangerously high cholesterol because the advice does not suggest it is lowered further.

Statins – cheap, safe and used since the 1980s – still play a vital role.

But the researchers, led by cardiologists at Imperial College London, warned much greater take-up of high-tech drugs is needed.

Some six million Britons take statins to ward off the risk of a heart attack or stroke.

Many have heart disease and are taking the pills to reduce the risk of a deadly decline.

Researchers calculated 29 per cent of these patients were not meeting the latest European

cholesterol goals. A second group of people take statins because they are at risk of developing cardiac problems in the next ten years.

If these patients are also taken into account, experts calculate 49.5 per cent are not hitting cholesterol targets.

The researchers yesterday presented their findings at the European Society of Cardiology congress.

Study leader Professor Kausik Ray of Imperial warned guidelines must be updated.

He predicted this could cut heart attacks and strokes by 11 per cent, and deaths by 5 per cent.

Prof Ray said: ‘Though statins are first-line treatment, it is clear that statins alone, even when optimally used, will not help the majority of patients achieve European Society of Cardiology cholesterol goals.

‘Only one in five very high risk patients achieve the 2019 recommended goals and to improve this will require use of combination therapy of more than one drug.’

The study of nearly 6,000 people – which took place in 18 European countries – included 600 British patients.

Across Europe as a whole, 22 per cent of patients with heart disease who were on highintensity statins met their cholesterol goals. In the UK this figure rose to 29 per cent. Among those receiving statins with a PCSK9-inhibitor, about two thirds attained their targets.

The European guidelines – which are considered gold standard – are much more stringent than in the UK and require those at high-risk to halve their cholesterol.

NICE last night acknowledged its advice needs to be updated and said it will publish this by 2023.

Professor Sir Nilesh Samani, medical director at the British Heart Foundation, said: ‘Statins are the first port of call for those with high cholesterol and are effective in many people, but we now have other drug options to lower cholesterol in those at highest risk.’

‘We have other drug options’