Hundreds of thousands more Irish could be prescribed heart drug statins after new research
Published 14/11/2013 | 10:13
HUNDREDS of thousands of Irish people could be prescribed statins to guard against strokes and heart attacks in light of recent research which has prompted a radical shift in US health guidelines.
The findings led to a recommendation in the US that anyone with a 7.5pc chance of a heart attack over 10 years should be considered for the drugs.
Guidance in Europe is that only those with a 20pc risk should be given statins.
Statins, which cost about 10 cent per patient per day, are the most commonly prescribed drugs in Ireland, used by an 250,000 adults.
Doctors used to prescribe them only to patients with a 30pc risk of a heart attack in the next 10 years, but this was lowered to 20pc in 2005.
Tonight experts predicted a further widening of eligibility following the new evidence.
Dr David Wald, a cardiologist at Queen Mary, University of London, said it would be “sensible” to lower the threshold, which would be “heading towards the point where statins may eventually be offered to everyone once they reach a certain age of around 55”.
He said: “For some years many have taken the view that the current risk threshold of 20pc over 10 years is too high a barrier for treatment.”
Helen Williams, a consultant pharmacist for cardiovascular disease and a member of the Royal Pharmaceutical Society, said: “I am not sure we will go all the way down to 7.5pc, but I was thinking 10 to 15pc myself.”
Statins work by lowering levels of “bad” LDL cholesterol produced by the body, which builds up fatty deposits in the arteries and raises the risk of coronary heart disease and stroke.
The drugs have been shown to reduce inflammation within blood vessels and the risk of stroke-inducing blood clots. A major review of 16 studies earlier this year suggested that they could also offer some protection against dementia.
Many doctors have long argued that statins should be more widely prescribed, with some studies recommending they be issued to everyone over the age of 50.
Others have warned of the dangers of prescribing the drugs to healthy people, because of the risk of side effects including serious kidney problems.
The new US guidelines, announced on Tuesday, followed a four-year review of evidence by the American College of Cardiology and the American Heart Association. Under the guidance, an estimated 44pc of men and 22pc of women would meet the threshold for statins – 33 million Americans.
The previous US guidelines recommended the drugs for about 15pc of adults, requiring patients to lower cholesterol to a target figure, but these numerical goals have now been abandoned.
Instead a formula taking into account other factors including age, gender and race is used to determine which patients may benefit. The review also recommended that statins should be taken by patients with heart disease, people aged between 40 and 75 with type 2 diabetes and those with a “bad” cholesterol rating of 190 or higher on the US scale, equivalent to about 4.9 on the scale used in Ireland.
Overall the review’s recommendations could double the number of Americans taking statins, the authors said. Professor Neil Stone of Northwestern University, the chairman of the expert panel behind the new guidelines, said: “The likely impact of the recommendations is that more people who would benefit from statins are going to be on them.”
“We’ve been undertreating people who need statin therapy,” said Dr Donald Lloyd-Jones, one of the experts who wrote the new guidelines. “Statins lower cholesterol levels, but what they really target is overall cardiovascular risk.”