February 12, 2014

expert reaction to draft guidance from NICE recommending wider use of statins

The National Institute for Health and Care Excellence (NICE) issued draft guidance which recommends that doctors lower the threshold for prescribing statins for preventative treatment of cardiovascular disease. 

Prof Donald Singer, British Pharmacological Society member, said:

“Heart disease, strokes and other serious disorders of the circulation are a major cause of premature ill health and death. Statins can help to prevent and reduce the severity of these serious medical problems. This initiative from NICE is important in extending to many more people protection from serious cardiovascular risk. Clear information will need to be made available on two key points: the need to combine statin use with a healthy lifestyle and addressing the other risk factors commonly present in people with high cholesterol, and information on the balance of risk versus benefit for these powerful medicines.”

Prof Simon Maxwell, Clinical Lead of Prescribe at the British Pharmacological Society and Professor of Clinical Pharmacology at the University of Edinburgh:

“I am very supportive of the recommendation for wider availability of statins for patients at risk of cardiovascular disease – even at just 10% risk over 10 years – given the frequency with which CVD events (e.g. heart attacks, strokes) damage people’s lives. However, I also believe that patients should be helped to make a truly informed decision about the benefits and risks of taking long term preventative therapy that will not make them feel any better in the short-term: we should avoid misapplication of such a recommendation without proper individual patient counselling.”

Helen Williams, Royal Pharmaceutical Society expert on heart medicines and consultant pharmacist, said:

“I welcome this consultation on the recommendation from NICE to lower the threshold for access to statin therapy for the first line prevention of heart attacks and strokes. This could significantly reduce cardiovascular disease, heart attacks and strokes across the population. Despite current guidance endorsing the use of statins in people with a 20% or higher risk of strokes or heart attacks too many people in this group are not getting the benefits of statins. We need to ensure that health care professionals are fully equipped to help patients make informed decisions about using statins. As a pharmacist I think it is important to look at how we can implement the change in guidance should it be finalised.”

Prof Peter Weissberg, Medical Director at the British Heart Foundation, said:

“Reducing your cholesterol level, whether that’s through medication or lifestyle changes, will reduce your risk of cardiovascular disease.

“The current guidance weighed the benefits of taking a statin against what was then the considerable cost to the health service. This pragmatic decision made sure that those of highest risk benefitted.

“However, as most people who have a heart attack or stroke have average cholesterol levels and since statins are now much cheaper it makes sense to reconsider the threshold.”