Study suggests all over 50s should consider taking statins
A recent study has suggested that everyone over the age of 50 should consider taking statins to cut their risk of stroke and heart attacks. Findings have shown that the cholesterol-lowering medication can cut the risk by a fifth, even in those who have no sign of heart disease.
The study, conducted by researchers from Oxford University, involved 175,000 patients and entailed 27 clinical trials, whereby participants were randomised to take either statins or placebo pills. The participants were grouped into one of five groups based on their risk of having a major vascular event in the next five years. The results, published in medical journal The Lancet, showed that statins reduced the risk of serious vascular events by 21% in each of the 5 risk groups, for each unit reduction (1 mmol/L) in their level of LDL cholesterol – the well-publicised “bad” cholesterol. These benefits were seen in both men and women, no matter what level of cholesterol they began with. Interestingly, the researchers found that even the group thought to have less than a 10% chance of a heart attack or stroke had their already small risk significantly lowered.
The researchers have added that most statins can reduce LDL by much more than just 1 mmol/L, so there could be even larger reductions in strokes and heart events if statins were used more widely.
Statins are already among the most widely prescribed drugs in the western world, and have long been known to help people at high risk of heart attack and stroke. Within the UK, they are typically only recommended for people who have a 20% or greater chance of developing cardiovascular disease within 10 years, with doctors considering a patient’s age, blood pressure, cholesterol levels and lifestyle when working out the risk.
Prof Colin Baigent, one of the researchers, said: “We’ve been taught over the years that high cholesterol is the thing that matters; you mustn’t have high cholesterol. But what we’ve actually learned is that, whatever your level of cholesterol, reducing it further is beneficial […] Half of [these] deaths come out of the blue in people who were previously healthy. If we are going to prevent that half of cardiac or stroke deaths, then we’ve got to consider treating healthy people. It can’t be done any other way.”
He, alongside fellow researchers, is now calling on authorities to review the evidence for giving statins to more people. However, these findings will further fuel a long-running debate over medicating healthy people, with some questioning whether it works at all and whether it is socially acceptable.
In terms of statins, side-effects represent a key issue, as they have been linked to liver problems, kidney failure, muscle weakness and an increased risk of diabetes. Other side effects of statins can include stomach disturbances, sleep and memory problems, depression and headaches.
The researchers said there was no evidence from the studies that those taking statins had an increased risk of developing cancer or of dying from non-vascular causes. However, they did acknowledge small increased risks of a more rare type of stroke, called hemorrhagic strokes. There was also a small increase in diagnoses of diabetes; nonetheless the researchers maintain that “the definite benefits of statins greatly outweigh these potential hazards,” concluding that treatment guidelines about who should and shouldn’t take statins “might need to be reconsidered.”
Responding to the findings, Prof Shah Ebrahim, from the London School of Hygiene and Tropical Medicine, has said: “This research provides further evidence that statins are an effective and safe way of reducing the risk of heart attacks and strokes even among people at quite low risk of these conditions. The benefits of giving statins to everyone over the age of 50 would probably save […] money in the long run, owing to the savings in health care costs from the heart attacks and strokes prevented.” However, he questioned whether it would be good for people or society to resort to mass medication for lifestyle issues. It would seem that this is a debate that will remain ongoing for some time.
Source – BBC Health News 17 May 12 & CTV.ca 17 May 12