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NICE: ‘Use more statins’

pharmafile | February 12, 2014 | News story | Sales and Marketing NHS, NICE, baker, cvd, statins 

NICE has decided more NHS patients ought to be considered at risk of cardiovascular disease (CVD) – and therefore advises that a greater number of people should be offered statins.

The UK health watchdog’s draft guidance, which is now out for consultation, recommends that people with a 10% risk of developing CVD within 10 years are offered statins – a significant change from the current guideline of patients with a 20% risk.

The update reflects the way that generic statins have decreased in price and increased in availability, and NICE says it also wants to allow consideration of new evidence on CVD risk assessment tools.

It recommends that people are assessed using the QRISK2 calculator, which takes into account whether or not they smoke, their cholesterol levels, blood pressure, and body mass index and then provides a percentage risk of developing CVD.

Long-term illness caused by CVD is increasing and about seven million people in the UK are estimated to be on statins already, at a cost each year of £450 million.

CVD, an umbrella term which takes in heart disease, stroke and peripheral arterial disease, was estimated to cost the NHS in England £6.9 billion in 2003, rising to £7.8 billion in 2010.

These conditions cause a third of all deaths (180,000 people) in the UK – despite death rates from CVD halving since the 1970s in England and Wales.

Around 80,000 deaths per year are caused by coronary heart disease alone, with 49,000 resulting from strokes. People who are socially deprived or on a low income are at greater risk, and rates in the north of England are higher than in the south.

While there are some risk factors which cannot be controlled – for example, age (particularly over 50 years), sex, ethnicity and family history – there is much that can be done about others, including smoking cessation, cutting down on alcohol, more frequent exercise and eating healthily.

Patients who look to mitigate these factors should then be offered high intensity statin therapy, NICE says.

“People should be encouraged to address any lifestyle factors,” said Professor Mark Baker, director of the Centre for Clinical Practice at NICE. “We also recommend that statins are now offered to many more people – the effectiveness of these medicines is now well proven and their cost has fallen.”
 
People with raised cholesterol levels and high blood pressure should reduce the amount of foods containing saturated fat they eat, such as meat, cheese and milk.

“They should exercise more and control their blood glucose levels by reducing their intake of sugar and by losing weight,” Baker added. “They should also stop smoking.”

The consultation closes on 26 March.

Adam Hill

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