New draft guidelines from the National Institute for Health and Care Excellent (NICE) calling for millions more Brits to take statins regularly in a bid to reduce heart attacks and strokes have given rise to a debate over the pros and cons of the drug.
So what are statins, and what are the arguments for and against increased prescribing of the medication? We take a look at the pros and cons.
What are statins?
Used to describe a group of medicines, statins aim to help lower the level of low-density lipoprotein (LDL), or 'bad cholesterol', in the blood, thereby reducing the risk of cardiovascular disease, the nation's biggest killer. The one-a-day tablets are commonly offered to people who have already been diagnosed with some kind of cardiovascular disease, including those who have suffered a heart attack, and those who are at high risk, typically with a one-in-five chance of developing a problem over the next ten years. Doctors typically advise various lifestyle changes be made alongside the drug.
The proposed guidelines from NICE suggest that the number of people being offered the drug should be widened to include lower-risk groups, as low as a one-in-ten risk of developing a problem. That could therefore include otherwise healthy folk in their 40s who have high cholesterol, as well as over 50s, because age is often a factor.
Statins have been used for over a decade, and though they do come with side effects, they also save lives. Cholesterol is one of the biggest risk factors for heart disease, stroke and disease of the arteries, and statins are known to slow the production of bad cholesterol in the liver. In a review of 90,000 users by the Medical Research Council in Oxford and the University of Sydney, the drug was found to reduce the risk of a fatal heart attack or stroke in high-risk users by about a third. They are said to be particularly beneficial for those who have already suffered a heart attack or stroke, have angina or peripheral arterial disease.
Side effects, including diarrhoea, headaches, fatigue and joint and muscle pain can be a problem, though experts suggest that unless the problems persist or worsen, the benefit provided by the statin still outweighs the negatives.
It is estimated that some 7,000 lives are saved each year in the UK because of statins.
Some doctors have suggested that there is not enough evidence that wider usage of statins would truly benefit those in lower-risk categories, and that much of the existing data has come from the pharmaceutical firms that make the drug. According to the BBC, in a survey of 500 GPs by the magazine Pulse, only half said they would take or recommend a family member to take statins based on the new proposed guidelines.
Side effects are another issue that have caused concern amongst experts. In a Dutch survey of 4,738 statin users, 27 per cent said they suffered from side effects, with 40 per cent of those experiencing muscle pain and almost a third saddled with joint pain. The poll also found that 16 per cent had digestion problems, and 13 per cent described memory loss as a side effect. The most commonly reported side effects include headache, nausea and insomnia, while between one in 100 and one in 1,000 people were susceptible to inflammation of the liver, blurred vision and weakness. Severe side effects such as jaundice, nerve and muscle damage were rarer, affecting fewer than one in 1,000 people.
However, there have also been questions as to how much benefit is gained in those that have yet to develop a problem. Researchers in the US estimate that in 100 people without a diagnosed heart condition who take statins for five years, 98 would gain no benefit whatsoever, and only one or two of those would avoid a heart attack that might have occurred otherwise.
It is important to bear in mind though that the proposed guidelines are just that - ultimately it will be down to doctor and patient to discuss the risks and/or benefits, and make their own decision on the statin front.
Do you take statins? Have you experienced side effects, and do the positives outweigh the negatives for you? Leave your comments below...