Statins – which side are you on?
Statins are among the most prescribed medicines in the UK – and lately one of the most controversial after the National Institute for Health and Care Excellence (NICE) updated its guidelines earlier this year.
Statins are frequently used as a preventative treatment and work to lower the level of cholesterol in your blood. High levels of ‘bad’ cholesterol in your body can lead to fatty deposits in the arteries, increasing the risk of cardiovascular disease, heart attacks and stroke.
Under the new guidelines, anyone with a 10% risk of developing cardiovascular disease within the next decade should be offered statins. Previous guidelines recommended starting preventative treatment for anyone with a 20% risk.
Under the lower threshold up to 4.5 million people living in the UK could be eligible for statins, a move the National Institute for Health and Care Excellence says could help prevent up to 28,000 heart attacks and 16,000 strokes each year.
The new guidelines received a mixed response; some welcomed the new guidelines while others were fiercely opposed.
Those for it say…
Those in favour of the new guidelines believe access to statins should be an option for those who want it.
At the moment, 1 in 3 deaths in the UK are caused by cardiovascular disease – 180,000 deaths each year. The NHS spends £8 billion in resources on cardiovascular disease, a number that could be reduced if more people who were at risk of developing it were taking statins.
By lowering the guideline of who can have access to statins, more people have the opportunity to make a proactive decision about their healthcare. Statins are inexpensive and it’s already proven that statins protect people who have had a heart attack or stroke from having a second.
The move to prescribe statins to people who have been identified as at a low risk of developing cardiovascular disease is based on extensive research and already common practice, the change in guidelines is simply a reflection of that.
Those against it say…
Critics of the guidelines point to side effects and the lack of published data showing any harm the drugs can do.
Many opponents argue that the benefits are not assured – those taking statins could still develop cardiovascular disease – and do not believe the potential benefits outweigh the risks. Statins can affect the liver in rare cases, and in about one in 10,000 cases taking statins can cause rhabdomyolysis, a serious condition which affects the kidneys.
Others take issue with the fact the guidelines effectively create a mass “medicalisation” of people who are not ill. There are many lifestyle changes that can also have a significant impact on reducing the risk of cardiovascular disease such as quitting smoking, maintaining a healthy diet, BMI and waist circumference and living an active lifestyle, and that rather than medicating patients who are not yet ill, there should me more emphasis on living the healthiest life possible.
Making up your own mind
Like any time there are conflicting opinions on any subject, it’s important to do your own research and make the decision that’s right for you. Your opinion about statins and whether or not you take them will reflect a complex range of factors including your medical history, cholesterol levels, current health and advice from your doctor.
If you’re interested in reading more on the subject, there are great resources online you can look to find more information.
NICE also published a useful patient decision aid that may be useful to anyone who has already been identified as at risk and whose doctor has recommended taking statins. To supplement this, NICE has also published a blog post that plainly explains some of the research and what it means for you.
If you’re interested in reading more about the controversy surrounding the change in guidelines, the Guardian published an overview earlier this year, and continues to update its website with the latest news on statins.
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