HAND OUT STATINS ON DEMAND, DOCTORS ARE TOLD

Up to 15 million more people could be given pills under new NHS guidance

GPs will prescribe lifesaving statins to anyone who wants them under new guidance aimed at preventing thousands of heart attacks and strokes.

drugs watchdog Nice has effectively axed the eligibility criteria for the cholesterol- busting pills after a major review found they were safe and rarely caused side-effects.

it means as many as 15 million more adults can request the 2p-a-day tablets on the NHS.

until now, doctors were told to offer the drugs to patients with a 10 per cent or higher risk of suffering a heart attack or stroke within a decade. But they will now be able to prescribe to anyone who asks for them, even if they have a much lower risk of cardiovascular disease.

professor Sir Nilesh Samani, medical director at the British Heart Foundation, said the National institute for Health and Care

Excellence (Nice) guidance was ‘ good news’. The landmark study last year revealed statins had been wrongly blamed for muscle pains that were actually a symptom of old age.

The University of Oxford researchers showed ‘definitively’ that warnings about the potential side-effect were unfounded and people’s complaints were largely ordinary niggles.

The ‘gold standard’ study, published in The Lancet, involved 155,000 patients and found an almost identical risk of muscle pain in people not taking statins.

Nice yesterday said the ‘ evidence is clear’ that statins were an ‘appropriate choice’ for people who wanted to reduce their risk of disease.

Sir Chris Whitty, the UK’s chief medical officer, recently warned that thousands of middle-aged people were dying of heart conditions because they did not get statins or blood pressure medicines during the pandemic.

The new guideline recommends statins can be considered as part of ‘shared decision-making’ between a doctor and patient for those who have not had a heart attack or stroke and have a risk score of less than 10 per cent. About eight million Britons already take the pills, but Nice estimates there are 15 million people in England aged between 25 and 84 with a risk score below the current threshold.

It recommends that people are assessed for their risk of developing cardiovascular disease by accounting for factors such as whether they smoke, cholesterol levels, blood pressure and body mass index.

People can be at risk from cardiovascular disease because of factors they cannot change, such as age, sex, ethnicity and family history. However, the draft guidance continues to recommend that risk factors which can be addressed should be managed. These include stopping smoking, reducing alcohol consumption, taking exercise and eating a healthy diet.

Doctors are advised to consider 20mg of atorvastatin where there is patient preference for taking a statin or concern that their calculated risk may be underestimated. Nice estimates that under this new recommendation, for every 1,000 people with a risk of 5 per cent over the next ten years who take a statin, about 20 people will not get heart disease or have a stroke because they take the tablet.

This figure doubles to 40 for those with a risk of 10 per cent, and for those with a risk of 20 per cent, around 70 would not get heart disease or have a stroke in the next ten years.

Nice agreed that focusing on increasing uptake among those with the highest risk of cardiovascular disease events would have more impact. For this reason, the draft guidance says that, while people at lower risk can be ‘considered’ for statin therapy, those at a higher risk should continue to be ‘offered’ statins.

Paul Chrisp, director of the centre for guidelines at Nice, said: ‘What we’re saying is that, for people with a less than 10 per cent risk over ten years of a first heart attack or stroke, the decision to take a statin should be left to individual patients after an informed discussion of benefits and risks.

‘The evidence is clear, in our view, that for people with a risk of 10 per cent or less over ten years, statins are an appropriate choice to reduce that risk. We are not advocating that statins are used alone. ‘It is the responsibility of GPs to explain the ways in which people can reduce their risk of cardiovascular disease.’

Professor Samani added: ‘Heart attacks and strokes still kill more people prematurely than anything else, with high levels of cholesterol being a major risk factor.’

‘The evidence is clear’