Statins: their role in tackling heart disease
Lifestyle Statins stake their claim as England’s most widely prescribed drugs.
In preventing heart attacks or stroke, the statistics are absolutely clear: statin tablets are part of the strategy to be considered, says blood fats expert Dr Robert Cramb, director of pathology and consultant chemical pathologist, at the Queen Elizabeth Hospital, Birmingham.
Statins are a group of drugs prescribed in the UK to help prevent cardiovascular diseases (CVD) such as a heart attack or stroke. Available in five forms, to lower bad cholesterol – simvastatin, atorvastatin, fluvastatin, pravastatin and rosuvastatin. Left untreated, cholesterol can build up in the arteries to affect blood flow to vital body organs such as the heart or brain.
Statins work by lowering the total amount of bad cholesterol in your blood by reducing the amount produced inside the liver.
CVD remains a major cause of British deaths. At the coalface of this problem are GPs, who are challenged to help manage this problem. But hindered by an increasingly inactive adult and child population, they have to confront the fact that drugs may be the only method to help some individuals. A family history of heart attack or stroke, inherited high cholesterol, diabetes, and other risk factors (smoking, high blood pressure, excess weight commonly start the discussion to improve diet and lifestyle but may ultimately culminate in the need for statin prescription.
With almost 30 years’ experience in use around the world, statins can now be prescribed with confidence, Cramb believes. GPs have a wide range of continually updated resources on which to support their decision to initiate statin therapy. This is usually life-long, as statins cannot cure CVD but instead help prevent it from getting worse or recurring. Statins can also reduce the chance of CVD developing in people at risk.
Cost-effective NHS pricing has also determined the leading status of one statin in particular - simvastatin – which has held the title of England’s most commonly prescribed drug for at least five years. Thanks to recent price cuts in statin stablemate drug atorvastatin, GPs now have a number of cost effective statin choices and between 2014-15 atorvastatin became NHS England’s fastest growing drug.
“Economically, it is hard to argue against recommending a treatment with drug costs of around £30 a year, when compared to the costs of having a cardiovascular event, affecting an individual’s quality of life and ability to work.”
- Dr Robert Cramb
But importantly, Cramb notes, that doctors should only prescribe a statin once they have carefully considered an individual’s risk of a CVD event and then only after discussion with the patient so that they understand the benefits of statin use balanced against the needs of life-long prescription and the low risks of statin side-effects. He says: “This should result in a properly informed decision and not one made on the basis of scientific research taken out of context.”