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Last Updated: Wednesday, 25 January 2006, 00:10 GMT
Millions more to get heart drugs
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Statins have come down in price
An extra 3.3 million people will become eligible for cholesterol-busting drugs, thanks to new NHS guidelines.

GPs will be urged to prescribe statins to those with a 20% risk of developing cardiovascular disease within 10 years, as well as those who have it.

Currently, the National Institute of Health and Clinical Excellence (Nice) recommends giving statins to those with a 30% risk.

It is hoped the change will cut the number of heart attacks and strokes.

Nice also hopes the widening of prescription guidelines will ultimately save the NHS money by reducing the number of people who have to undergo costly heart operations such as by-passes.

We estimate that around 3.3 million people will become eligible for statin therapy
Professor David Barnett
Nice

Nice looked at five different statins currently licensed in the UK - atorvastatin, fluvastatin, pravastatin, rosuvastatin and simvastatin.

Only one of these, simvastatin, is available over the counter in pharmacies in a low 10mg dose.

Cardiovascular disease (CVD) causes around 238,000 deaths in the UK yearly, and is also a significant cause of ill health.

Statins reduce the level of harmful cholesterol in the blood by slowing down its production in the liver.

Deposits of this type of cholesterol can cause thickening of the arteries, and increase the risk of clots.

Some 1.8 million people already receive the drugs on the NHS.

Professor David Barnett, who chairs the Nice committee which developed the guidance, said the ruling was significant.

"We estimate that around 3.3 million people will become eligible for statin therapy as a result of these recommendations, which offer clear guidance about which patients should be started on treatment with a statin and how doctors should go about it."

'Affordable'

He also pointed out that the guidance stressed the importance of other strategies for managing CVD risk, such as lifestyle measures like stopping smoking.

The Department of Health said statin prescribing had been rising by 30% a year since the National Service Framework for Coronary Heart Disease was introduced.

A spokesman said the new guidance would encourage the NHS to continue identifying patients who could benefit from the drugs, reducing incidence of the disease and saving lives.

He added: "There have been recent dramatic drops in price for the most commonly prescribed statins.

"While prescribing has gone up, costs have come down. This should make the new guidance affordable under the current settlement."

Treating risk

Professor Peter Weissberg, of the British Heart Foundation, said statins had been previously restricted to patients with established CVD or a high risk of developing it.

"The new Nice guidelines substantially lower the threshold for treating patients at risk so that thousands more patients will become eligible for these life-saving drugs.

"The Nice guidelines coincide with recently published advice to GPs urging them to assess the risk of developing heart disease or stroke in all their patients over 40 years of age.

"The new Nice guidelines mean that when such people at risk are identified, they can now be treated."

'Effective'

Medical Research Council scientist Dr Colin Baigent said the new guidance was good news for patients.

He said statins were "wonderfully effective" in reducing cholesterol levels and had significant benefits.

"It will reduce the risk of vascular events like heart attacks, strokes and heart operations," he said.

The Blood Pressure Association (BPA) also welcomed the new guidance and said its own research on people with high blood pressure found that while 80% of respondents had had their cholesterol checked, less than a third were taking a statin.

Professor Gareth Beevers, a BPA trustee, said: "This gives cause for concern given that the majority of those were at a relatively high risk of cardiovascular disease."

He cited recent research which showed people with high blood pressure could cut their risk of heart attack and stroke by half by taking a combination of newer blood pressure medicines with a statin - regardless of cholesterol levels.


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