Should more people be taking cholesterol-boosting statins?

statinsStatins are the most commonly prescribed type of medicine within the UK, taken by millions of people to help lower their ‘bad’ low-density lipoprotein (LDL) cholesterol levels in the blood.

A large proportion of people may only be prescribed statins on the basis of their future risk though, for instance if there is a chance of the person developing cardiovascular disease, if there is a strong family history of cardiovascular disease, or determined by the person’s age.

However, experts have warned that this is simply excluding a great number of people who may benefit from taking statins, which include atorvastatin, rosuvastatin, pravastatin and more. The warnings came as part of a study published in the American Heart Association’s journal, Circulation.

Scientists based at the McGill University Health Centre (MUHC) in Montreal, Canada, argue that actually younger people with high cholesterol levels should be prescribed too. They estimated that there at least 9.5 million lower-risk, young people who would benefit from statins that aren’t taking them at the moment.

Dr George Thanassoulis, director of preventative and genomic cardiology at MUHC, said: “Targeting statin treatment to this group would prevent an additional 266,000 heart attacks and strokes over 10 years.”

In determining who they thought would receive health benefits from statin therapy, the scientists studied data from 2,134 participants of the National Health and Nutrition Examination Survey, a nationally-representative US cohort that spanned from 2005 to 2010.

The survey comprised of around 71.8 million Americans who were deemed eligible for statins. Those involved in the study then used a 10-year risk based approach, in addition to an individualised benefit approach, comparing the two different ways of looking at eligibility for statins.

Dr Thanassoulis commented: “Using a benefit-based approach, we identified 9.5 million lower-risk Americans not currently eligible for statin treatment, who had the same or greater expected benefit from statins as higher-risk individuals.

“These individuals were lower-risk because they were younger but they also had higher levels of low-density lipoprotein cholesterol which we have known to be an important cause of heart disease.”

The study’s findings may lead to health professionals reconsidering who should be prescribed the cholesterol-boosting drugs, and possibly recommending that people previously thought of as too young to be at risk of a heart attack, should be eligible for them.

Dr Thanassoulis said: “Our analysis shows that they would benefit from treatment, even in the short term, and therefore should be eligible for statin treatment.”

The scientists involved in the study argue that this could help to prevent a large number of people suffering with cardiovascular disease in the future.

“For too many, the present approach starts too late; an earlier start will multiply the lives save,” Dr Thanassoulis added.

The next step for the team that undertook the study will be the creation of a web interface to enable other physicians to take advantage of the new calculation model, and hope their method will result in new guidelines being set on identifying people who could benefit from statins.

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