Statins should be offered to anyone who wants them under new NHS guidance

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Anyone who wants to take statins should be able to opt for the cholesterol-busting drugs under radical new NHS guidance.

Currently around 8 million people in the UK take the drugs to ward off heart attacks and strokes.

But England’s chief medical officer is concerned by a sharp rise in heart deaths since the pandemic, which may be caused by a fall in the numbers being put on medication during lockdown.

The new draft guidance from the National Institute of Health Care Excellence (Nice) says the decision about whether to take the drugs should be left to individual patients.

While GPs will continue to offer the cheap pills proactively to all patients found to have a 10 per cent risk of heart attack or stroke in the next year, those with far lower risks can also opt for them, following a discussion with their doctor, the advice states.

Estimates suggest that around 17 million people in England qualify for statins under current criteria. The change could mean almost twice as many could become eligible.

It comes amid deep concern about rising heart deaths in the UK.

Latest figures for England and Wales suggest around 1,000 excess deaths a week, with only a minority linked to Covid.

Paul Chrisp, director of the Centre for Guidelines at Nice, said: “What we’re saying is that, for people with a less than 10 per cent risk over 10 years of a first heart attack or stroke, the decision to take a statin should be left to individual patients after an informed discussion of benefits and risks.

“The evidence is clear, in our view, that for people with a risk of 10 per cent or less over 10 years, statins are an appropriate choice to reduce that risk.”

Officials said they still urged lifestyle overhauls, to reduce the chance of heart disease.

‘Understanding of the risks’

Dr Chrisp said: “We are not advocating that statins are used alone. The draft guideline continues to say that it is only if lifestyle changes on their own are not sufficient, and that other risk factors such as hypertension are also managed, that people who are still at risk can be offered the opportunity to use a statin, if they want to. 

“They don’t have to, and their decision should be informed by an understanding of the risks and tailored to their values and priorities.”

He said the new guidance said the decision to take statins was a matter of personal choice.

“It may well be that many people will say that they are happy to accept a risk of having a heart attack or stroke rather than taking statins every day – which is absolutely their prerogative. They just need to know and understand the level of risk – and this in itself can be a complex discussion,” he said.

If 1,000 people with a 5 per cent chance of heart attack or stroke within a decade, were put on statins, around two cases would be prevented, Nice’s estimates suggest.

With the current threshold of 10 per cent, around four cases are prevented.

People can be at risk of heart disease because of factors they cannot change including their age, sex, ethnicity and family history.

The draft guidance continues to recommend that risk factors that can be addressed should be managed.

These include stopping smoking, reducing alcohol consumption, taking exercise and eating a healthy diet.

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