Thousands at risk of heart disease are not given statins

STATINS are not being prescribed to hundreds of thousands of patients at high risk of heart disease, Public Health England data reveal.

Four in five people who attended the Government’s flagship NHS Health Check scheme in the past five years and were found to need the cholesterollowering drugs were not given them, equating to approximately 162,000 patients a year, the figures show.

Responding last night, health leaders questioned the value of the £32million-a-year “world-leading” Health Check programme, launched in 2009 to stave off cardiovascular diseases (CVD), principally in people aged between 40 and 74 who have not yet shown any symptoms.

“The Health Check was designed exactly to catch the difficult-to-catch people, but these numbers [prescription of statins] are very, very low,” said Professor Francesco Cappuccio, president of the British Hypertension Society.

“Once you already have symptoms of these conditions, it can already be too late.”

Prof Cappuccio said he himself had recently undergone a Health Check, which is usually performed in a GP surgery by a nurse, and had found the process “formulaic” and “ridiculous”.

He said that “inertia” among GPS, as well as patchy funding for the Health Check and a failure to accurately follow national guidelines could account for the shortfall in statin prescriptions.

Previous studies have indicated that failing to prescribe statins to those in need can cost “tens of thousands” of lives. CVD remains the biggest cause of death in the UK, and public health chiefs are warning that the dangers increasingly apply to younger people, because of rising obesity.

However, it is estimated that between 50 and 80 per cent of cases are preventable, and National Institute for Health and Care Excellence guidelines state that if a person has a 10 per cent or greater chance of a heart attack or stroke in the next decade, the benefits

of statins outweigh the risks. Nearly 3,960,000 people aged 30 to 85 have a 10-year CVD risk of 20 per cent or more, but of these only 49 per cent are given statins. Overall, one in seven English adults uses the drug, according to NHS Digital.

While statin prescription rates had been shown to be low in previous studies, the new figures reveal that Health Check specifically is failing to solve the problem. The official PHE figures follow research by the University of Birmingham last year which showed that despite pressure to widen the use of statins, the proportion of those with the worst outlook taking the drugs had dropped.

As well as the large “diagnosis and treatment gap” for those who would benefit from statins, the PHE data covering March 2013 to 2018 revealed only one in 12 Health Check attendees at high risk of CVD is prescribed antihypertensive medication. Over the past five years, 48 per cent of eligible patients have undergone the check.

Professor Helen Stokes-lampard, chairman of the Royal College of GPS, said: “Patients can often benefit from preventive medications, such as statins which can be effective drugs at preventing cardiovascular disease, and the NHS Health Check can sometimes provide an opportunity to flag this.

“But the College has concerns about the efficacy of blanket NHS health checks, such as the potential for overdiagnosis of patients, and particularly at a time when general practice is under intense resource and workforce pressures.”

Dr Matt Kearney, national clinical director for cardiovascular disease prevention at NHS England, said: “The decision to prescribe what is likely to be a daily medication for life is complex and based on each patient’s individual circumstances. For example, many patients want to try adjusting lifestyle factors first, some are anxious about taking too many medications or sideeffects, and others are fearful of stories about statins in the media.”

NHS research has suggested the Health Check scheme in England costs £320million over 10 years, before savings associated with prevented diseases are factored in.