New guidance recommends millions more to take statins

There could soon be millions more British patients being prescribed cholesterol-lowering statins such as atorvastatin or pravastatin to safeguard against heart attack and stroke, following the publication of new guidelines in the United States of who would benefit from taking statins; the first such guidance to be released in the US in a decade.

The updated guidelines are based upon the findings of a new study conducted over four years by the American Heart Association and American College of Cardiology, who decided to ‘think outside the box’ so to speak, as to what constitutes putting someone at a risk of heart attack and/ or stroke.

The researchers, unlike many of their peers who conduct similar studies, shifted their interests away from high cholesterol and instead utilised a formula to calculate risk and looked at a person’s age, gender, race, together with certain health factors like smoking.

“This guideline represents a departure from previous guidelines because it doesn’t focus on specific target levels of LDL, or bad cholesterol, although the definition of optimal LDL cholesterol has not changed,” Dr Neil Stone, author of the report, said in a statement.

Dr Stone added: “The likely impact of the recommendations is that more people who would benefit from statins are going to be on them.”

Dr Donald Lloyd-Jones, one of the experts who help to draft the new guidelines, said: “We’ve been undertreating people who need statin therapy. Statins lower cholesterol levels, but what they really target is overall cardiovascular risk.”

More African-Americans – a demographic usually at a higher risk of stroke – could be prescribed statins in accordance to the new guidelines.

Under the guidance, there would now be approximately 44% of men and 22% of women who would be deemed suitable for taking statins – or 33 million Americans.

This is in stark contrast to previous US guidelines that meant only 15% of adults in America were recommended for statin treatment, whereby patients had to have a target set to lower their cholesterol to. These numerical targets have now seemingly been abandoned.

In creating the guidelines, the panel analysed four particular groups who they believed to need statins more than most: patients currently with heart disease, people with LDL levels of 190 or higher due to genetic risk, adults aged between 40 and 75 with type 2 diabetes and older adults with a 10-year risk of heart disease in excess of 7.5%.

Those in the panel also stressed the importance of a “diet pattern” which includes fruit, vegetables and whole grains, with all adults engaging in moderate to vigorous exercise three to four times per week.

Many of the patents on statins have expired, with significantly cheaper generic statins now available. Crestor (rosuvastatin), a statin manufactured by AstraZeneca, still remains under patent however and in 2012 alone the drug had impressive sales of $8.3bn (£5.2bn).

Statins are actually the most commonly prescribed drugs in the UK, used by almost a tenth of the population. As cholesterol is still the primary factor in the process of prescribing statins, it is worth noting that NHS guidelines state that LDL cholesterol should not be higher than 3.0 and overall cholesterol no higher than 5.0.

Statins help to cut heart attack deaths by half

Firstly, Medical Specialists Pharmacy would like to wish everybody a slightly belated Merry Christmas and we hope everyone has had a fantastic few days with their family, friends and loved ones.

Secondly, we have already touched upon one group of people who may be vulnerable at Christmas time; asthmatics. However, those at risk of high cholesterol and heart problems need to be particularly cautious as well over the festive period.

Yesterday (Dec 26) is a day notorious for a high number of cardiac-related health problems such as heart attacks, heart failure and arrhythmias. A 2004 study conducted by researchers at the University of California, San Diego and Tufts University discovered that heart-related deaths go up by almost 5% during the Christmas holidays.

Some of the increased deaths can be attributed to a number of causes such as alcohol abuse as people already at risk of heart problems ignore the warnings and consume alcohol in excess, and some of the tragic fatalities are down to a build-up of Cholesterol – an important component of the blood stream that works at repairing body cells. However if excess cholesterol is not efficiently removed from the blood stream, it can pose a serious problem and cause deadly health issues such as stroke, heart attack and coronary heart disease.

As everybody is aware, stress levels for the majority of the UK and indeed around the world are at their peak over Christmas time as we frantically rush around for presents, planning time to see family and friends, and sorting last minute arrangements. Unfortunately stress and cholesterol are closely linked and when our stress levels increase, the production of two hormones – cortisol and adrenaline also increase.

Cortisol is known as the ‘stress hormone’ and it raises the sugars (glucose) in the bloodstream. Prolonged levels of cortisol have been shown to be connected to increased abdominal fat – linked to higher levels of ‘bad’ cholesterol (LDL) and lower levels of ‘good’ cholesterol (HDL), which can lead to all kinds of heart problems.

Cholesterol lowering medicines known as ‘Statins’ have been in the news throughout 2012 as health experts uncover more exciting findings about their capabilities. As stress and over indulgence of fatty foods increase our cholesterol over Christmas, it may come as good news to learn that British Heart Foundation statistics show that deaths from heart attacks have been cut by half, saving the lives of millions of people and this has been largely down to ‘wonder drug’ statins such as Crestor and Lipitor.

According to figures released by the British Heart Foundation, between the years 2002 and 2010 the death rate in men dropped from 78.7 deaths per 100,000 men to just 39.2 deaths per 100,000 men. Over the same 8 year block there was also a decrease in the death rate for females, 37.3 deaths per 100,000 women in 2002 fell to 17.7 deaths per 100,000 women in 2010.

The higher use of statin medication and blood thinning medication in conjunction with such lifestyle factors as fewer people now smoking have resulted in the decrease in heart attacks and other related problems. In addition, more advanced treatment than previous years means that those who do suffer from a heart attack, have a much better chance of surviving.

Professor Peter Weissburg, medical director of the foundation, said: “The last decade has seen excellent progress in heart attack prevention, treatment and care which has resulted in a dramatic reduction in the number of people dying from heart disease. Statins are an important part of that success story. They have undoubtedly changed the face of heart disease treatment for the better and there can be little doubt that there are thousands of people alive and well today because of statins. Whilst some people do experience irritating side effects, they are very rarely life threatening and the benefits far outweigh any risks. The progress we have witnessed over the last 10 years is something to celebrate but coronary heart disease is far from beaten and is still the single biggest killer in the UK. We must tackle the problem of inequalities which place an unfair burden of heart disease on our poorest communities. By dealing with the root causes of heart and circulatory disease – diet, smoking and lack of exercise – we should continue to see a decline in the numbers dying from a heart attack.”

Prescriptions for statins are now an incredible 15 times higher than 20 years ago, with estimates showing that approximately eight million people in the UK take statins every day. They work out to cost around just 40p per day and their benefits have led for calls for even more ‘healthy’ adults to be prescribed them too.

Thankfully, Medical Specialists Pharmacy provides private and confidential online consultations for statins, and for suitable patients our in-house doctors can prescribe statin medication such as Lipitor and Crestor, and our in-house pharmacists can dispense to patients within just 24 hours. We also dispense statins for patients who can provide a private prescription. If all that wasn’t enough, we also have the legally available generic Atorvastatin at much lower prices for suitable patients.