More than 12,000 people are needlessly suffering heart attacks – Daily Mail
More than 12,000 people in Britain are needlessly suffering heart attacks every year because they aren’t taking their statins, a study suggests.
The daily pills, which slash bad cholesterol levels, are proven to save thousands of lives each year and are doled out to millions of patients worldwide.
But researchers warn many patients prescribed the drugs aren’t sticking to their doctors’ advice to ensure they take them each day.
Scientists now say patients should be given stronger doses of statins to ensure that they receive the full benefit of the cheap pills.
Statins could prevent thousands of heart attacks and strokes if people regularly took higher doses, a study led by Imperial College and the University of Leicester found
The suggestion comes from researchers based at Imperial College London and the University of Leicester, who conducted the trial.
They looked at the use of the drugs in around 16,700 people who had already suffered cardiovascular events, such as a heart attack or stroke.
An analysis of the data found just 48 out of 1,000 patients suffer a heart attack if they take stronger statins once a day.
In comparison, the real figure is around 72 out of 1,000 patients taking statins – thought to cost the NHS around £2 a month per patient.
The experts therefore concluded that taking more powerful drugs, and sticking to them, could cut a patient’s risk of a heart attack.
Lead author Professor Kausik Ray said: ‘The basic message here is that long-term adherence achieves better long-term cholesterol reductions.
‘In terms of risk reduction, we can see the people who do the best are those who are adhering to the recommended dosage and are on more potent drug regimens.
WHY ARE STATINS CONTROVERSIAL?
Statins are the most commonly prescribed drug in the world and an estimated 30 per cent of all adults over the age of 40 are eligible to take them.
The cholesterol-lowering drugs are given to people believed to have a 10 per cent or higher risk of developing cardiovascular disease or having a heart attack or stroke within the next 10 years.
They are proven to help people who have suffered heart problems in the past, but experts say the thresholds may be too high, meaning benefits are outweighed by side effects for many people.
Nearly all men exceed the 10 per cent threshold by age 65, and all women do so by age 70 – regardless of their health.
Commonly reported side effects include headache, muscle pain and nausea, and statins can also increase the risk of developing type 2 diabetes, hepatitis, pancreatitis and vision problems or memory loss.
Research published in the Pharmaceutical Journal last year found taking a daily statin for five years after a heart attack extends your life by just four days, new research reveals.
And Dr Rita Redberg, professor at the University of California, San Francisco told CNN in January that of 100 people taking statins for five years without having had a heart attack or stroke, ‘the best estimates are that one or two people will avoid a heart attack, and none will live longer, by taking statins.’
But the official view in the UK is a positive one.
The Medicines and Healthcare products Regulatory Agency (MHRA) advises liberally prescribing the drugs.
‘But if someone is not going to take a treatment as recommended, they may actually be better off on higher doses of statins.’
Professor Ray explained this would allow patients to achieve greater cholesterol reductions when they are taking the medication.
Doctors are cautiously prescribing doses which are too weak, or that people are forgetting or stopping their tablets due to side effects, the researchers said.
Statins are taken by six million people in Britain to reduce their cholesterol and are proven lifesavers for those with heart problems. Up to 30million in the US meet the medical threshold to take the drugs.
But an Australian study revealed last month that 45 per cent of pensioners had stopped taking them.
The authors said side effects including muscle pain, sleep problems and impotence put some people off taking the drugs.
The latest study gave people an overall score for whether they had missed or stopped either statins or a drug called ezetimibe, and how strong their drugs were.
Then they were tracked for an average of three years to see if they suffered another heart attack, stroke or other cardiovascular event.
The most powerful drugs cut cholesterol by 50 per cent, with the least intense statins reducing it by only 30 per cent.
Professor Ray, of Imperial, added: ‘With LDL cholesterol, also known as “bad” cholesterol, the lower it is the better.
‘We know once you have one heart attack or other cardiovascular event, you are at much higher risk of more events in future and that lowering your LDL cholesterol levels is key to improving outcomes.
‘For these patients, taking the right medication, at the right dose, at the right time – and sticking to this regimen – is critical in lowering their risk of future cardiovascular events.’
The researchers said low adherence could be curtailed through slow release drugs which patients are required to take less frequently.
Leading heart experts have today welcomed the results of the study, published in the journal JAMA Network Open.
Professor Sir Nilesh Samani, medical director at the British Heart Foundation, said: ‘This is real-world evidence that taking your medicine as prescribed really can make all the difference.
‘If you’re taking statins, it’s essential that you continue to take them regularly, as advised by your doctor.’
Professor Liam Smeeth, at London School of Hygiene and Tropical Medicine, said: ‘These results are entirely in agreement with the evidence from previous clinical trials.’
He added the findings highlight the importance of people taking their statins reliably over the long-term.
Guidelines in the UK and US both recommend prescribing a patient statins if they have a 10 per cent risk of heart disease within the next 10 years.
And, though the drugs are proven to lower this risk, statins are controversial among the medical community because of their potential side effects.
Supporters of statins, including the UK health watchdog Nice, say the pills should be prescribed more widely to prevent thousands of early deaths.
But many medics are uneasy with the ‘overmedicalisation’ of the middle-aged, which sees statins doled out ‘just in case’ patients have heart problems in later life.
Yet they do agree that for high risk patients, such as heart attack victims, statins are proven lifesavers, slashing the chance of a second attack.
High levels of bad cholesterol can lead to a hardening and narrowing of the arteries and cardiovascular disease (CVD), which kills 150,000 people each year in the UK and 610,000 in the US.
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