The Debate Over Statins

My previous two posts were investigating Cardiovascular Disease (CVD) and Statins, which are used to combat CVD. Now we have a basic understanding of those two, I am going to launch into the topical debate over the use of Statins in the United Kingdom. Currently, between six and seven million people take Statins as part of their medication every day. They are prescribed either to people who are healthy yet also at risk of Heart Disease or to prevent heart attacks or strokes in those who have already had problems. The current cost to the NHS is estimated at around £450 Million for Statins alone but this figure is a lot less than what it would cost the NHS had they not used this preventative measure and simply had to treat patients who had already contracted CVD or encountered other problems. The current status quo, as mentioned in previous articles is that Statins are prescribed to people who have a 20% or greater risk of developing cardiovascular disease within the next 10 years. This figure is provided by the NHS drugs watchdog - NICE (the National Institute for Health and Clinical Excellence). However, new research published on Lancet of 175,000 patients concluded that even those patients who were at very low risk seemed to benefit from taking Statins.

The debate comes in when some wonder whether or not it is beneficial or even socially acceptable to over medicate healthy people. The study examines patient data from 27 different Statin studies, finding that Statins significantly reduced the risk of heart attack and stroke for everyone. Doctors currently prescribe Statins to those who are above a certain threshold of risk and consider the patient's age, blood pressure, cholesterol levels and lifestyle. Since Statins mainly target cholesterol levels and from the previous two articles, we have deduced that cholesterol is a significant risk factor is high cholesterol, it seems logical that reducing the cholesterol levels are of paramount importance when combating heart attacks and strokes. The study though suggests that regardless of how low cholesterol levels are, further reducing them would always be beneficial. It suggests that the threshold of people who are at risk of 20% of developing CVD within ten years should be reduced to 10% instead. This would mean another five million people in the United Kingdom alone. Indeed, if the benefits are as great as they are made out to be we may even see some people calling for all people above a certain age, for example 50 years old being prescribed the Statins. Since I cannot argue with the validity of the study and shall wait for NICE's review on it, I shall only comment on the ethical implications with giving drugs to healthy people.

The study seems to claim that there is a possibility of 10,000 fewer heart attacks and strokes every year with 2,000 people being saved by taking Statins. The main thought process is that the only way to prevent strokes and heart attacks which are known to come out of the blue is to prescribe drugs to healthy people. However, we must also explore whether or not any potential side effects are associated with taking the Statins. In my previous article, I did say that they were acknowledged to be one of the safest drugs in circulation but they do still have side effects, however few and far between these may be. Statins have been linked to liver problems, kidney failure, muscle weakness and an increased risk of diabetes. Therefore, healthy people taking the Statins could potentially have their good health compromised.

Both sides of the argument must be considered by NICE when they review whether or not to review their current guidelines. However, it is my contention that Statins should be prescribed on a larger scale, whatever that may be, as it will do the population more good than harm and will save the NHS millions of pounds at the same time. It is not currently known who will react badly to Statins and who may not want to as they already consider themselves health so NICE may decide to implement any new guidelines with a trial period when running the new system.