More than 12,000 people are needlessly suffering heart attacks

More than 12,000 people in Britain are needlessly suffering heart attacks every year because they aren’t taking their statins, a study suggests. 

People who took high-intensity statins correctly at least 80 per cent of the time were around 33 per cent less likely to die from a cardiovascular event.   

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. 

The solution to low adherence is to give patients higher doses of statins to make up for the medication they have missed, the researchers said. 

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 

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 

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 

Researchers led by Imperial College and the University of Leicester looked at their use in more than 16,700 people who had already suffered cardiovascular events like a heart attack or stroke.   

There was a  found people who took high-intensity statins, and took them correctly at least 80 per cent of the time, were around 33 per cent less likely to die from or have another cardiovascular event.

By comparison, those patients on the lowest intensity treatment and with poor adherence had a risk reduction of just five per cent compared to those not on statins. 

That result, applied to the half a million heart disease patients in the UK, shows 12,000 people could be saved. 

Cholesterol lowering treatments are less effective if patients do not take a drug regularly, skip days, or stop altogether – especially if they see or feel no immediate benefit from taking a drug.

This is particularly important as high cholesterol levels in the blood may not cause any noticeable symptoms compared to other conditions.

‘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,’ Professor Kausik Ray, lead author from Imperial College London’s School of Public Health said. 

‘But if someone is not going to take a treatment as recommended, they may actually be better off on higher doses of statins so that when they are taking the medication, they are achieving greater cholesterol reductions.’  

That result, applied to the half a million heart disease patients in the UK, shows 12,000 people could be saved.

Professor Kausik Ray, who led the study from the School of Public Health at Imperial, said: ‘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.’ 

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.

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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.  

Statins are taken by six million people in Britain to reduce their cholesterol and are proven lifesavers for those with heart problems.

But an Australian study revealed last month that 45 per cent of pensioners had stopped taking them, with side effects including muscle pain, sleep problems and impotence putting some people off.

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 researchers conclude from their results that among the 23 per cent of people taking the strongest statins, and taking them properly, 48 out of 1,000 should have a cardiovascular event.

But in the real world, 72 out of 1,000 people die or suffer a cardiovascular event despite being on statins. They therefore conclude that taking more powerful drugs, and sticking to them, could cut someone’s risk by a third.

The most powerful drugs cut cholesterol by 50 per cent, with the least intense statins reducing it by only 30 per cent.

People with type 2 diabetes and chronic kidney disease may also have a third lower risk of a cardiovascular problem, according to 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.’ Liam Smeeth, Professor of Clinical Epidemiology at London School of Hygiene and Tropical Medicine, said: ‘These results are entirely in agreement with the evidence from previous clinical trials, showing that statins prevents heart attacks and deaths due to cardiovascular disease.

‘The study highlights the importance of people taking their statins reliably over the long term, and the benefits of using the higher doses of statins that are now widely recommended in clinical guidelines.’    

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