Page last updated at 23:29 GMT, Tuesday, 27 May 2008 00:29 UK

1.5m more to get cholesterol drug

Simvastatin
Statins help reduce the risk of heart attack and stroke

The number of adults prescribed cholesterol-busting statin drugs in England and Wales is set to soar under new national guidelines.

GPs are being asked to trawl through patient records to pick out "high-risk" patients who would benefit from them.

The National Institute for Health and Clinical Excellence (NICE) estimate 1.5m extra adults will get treatment.

But the British Heart Foundation warned those most at risk may still miss out on preventative care.

It comes just a few months after the government announced vascular screening for all 40 to 74 year olds.

It ensures an efficient and equitable method of targeting treatment to those most likely to benefit
Dr John Robson, guideline chair

Cardiovascular disease accounts for around one in three of all deaths.

Under the latest recommendations, GPs would use computer software to pick out those aged 40 to 75 years who are likely to be at high risk of having a heart attack or stroke within the next 10 years.

The risk assessment will be based on information such as age, sex, blood pressure and whether a person smokes and not just on whether or not they have high cholesterol.

It will also take into account ethnicity and a patients' family history of heart disease.

Patients will get invited into the surgery to double-check their risk and to be given lifestyle advice in addition to being offered a prescription for simvastatin, the cheapest of the statins.

Prevention

NICE said the "systematic identification" of these patients, who may not even realise they are at risk, would prevent 15,000 heart attacks and strokes every year.

About 4m people in England and Wales are already taking statins, they estimate.

The additional drugs will cost 35m annually with 28m for identifying those at risk in the first year.

Dr John Robson, a GP and chair of the guideline group, said it was a "major public health initiative" and would be a welcome addition to the governments' vascular screening programme.

"It ensures an efficient and equitable method of targeting treatment to those most likely to benefit," he added.

Professor Steve Field, chairman of the RCGP, said NICE were right to move towards preventing illness rather than just patching people up when they are ill.

"There is evidence that if we can identify those at risk early enough, we can have a dramatic effect in helping people change their lifestyles and improve their health through specially targeted interventions such as smoking cessation and earlier access to treatment."

But Professor Peter Weissberg, medical director for the British Heart Foundation said relying on patients to attend GP surgeries for assessment will fail to reach many of those from socially deprived and ethnically diverse communities who are most at risk.

"This issue will have to be addressed if the government's vascular risk assessment programme is to achieve its aims," he said.

He also criticised the decision by NICE to not advocate continued monitoring of cholesterol levels to make sure people at high risk are responding appropriately to statins.

"This 'fire and forget' approach is likely to result in many patients being inadequately treated."

A Department of Health spokeswoman said they were still working on plans for vascular screening for those aged between 40 and 74 years to minimise their risk of developing disease.




SEE ALSO
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