Half of the people who have prescribed statins remain at a high risk of heart disease because the pills are unable to lower their cholesterol, a large study suggests.
Experts called for a much more tailored approach to the use of statins in the aftermath of the & # 39; clearly alarming & # 39; findings.
The study of 165,400 people, led by the University of Nottingham, showed 49 percent of patients, since the drugs did not see their cholesterol fall to a healthy level within two years.
Researchers think this may have to do with the genetic make-up of certain people that makes the pills ineffective, or it may be that other medicines that they use disrupt the effect of statins.
However, another theory implies that many people in the study may have stopped using their statins, and therefore they have seen no effect.
Statins are the most prescribed drug in the world and an estimated 30 percent of all adults over the age of 40 are eligible to take them (stock)
Approximately six million people in the UK use cholesterol-absorbing statins and prevent 80,000 heart attacks and strokes each year, at a cost of around £ 20 per year per patient.
The drugs are developed to the level of & # 39; poor & # 39; Lowering LDL cholesterol in the blood, reducing arteries and reducing the risk of heart attacks and strokes.
But the new study, which used GP records from patients in the UK, discovered that only half of the prescribed statins for patients saw the response they expected.
The researchers found that statins from 51 percent of patients were incredibly effective – lowering cholesterol by at least 40 percent within two years.
But for the other 49 percent there was no significant effect.
And those patients who did not respond to the pills were 22 percent more likely to develop cardiovascular disease than those who did.
The researchers admitted that the data only showed whether each participant had prescribed statins – not whether they actually used it – and therefore urged patients not to stop taking their medication until there were more definitive findings.
But research leader Dr. Stephen Weng said: “We need to develop better ways to understand differences between patients and how we can adapt more effective treatment to those millions of patients who are simply prescribed statins.
& # 39; Our research has shown that almost half of the patients are prescribed statins that are highly effective and offer significant protection against cardiovascular disease.
& # 39; But for the other half – whether it's because of your genetic make-up, side effects, sticking to treatment or other medicines – we don't see the intended benefit. & # 39;
WHAT IS HIGH CHOLESTEROL?
Cholesterol is a fatty substance that is vital for the normal functioning of the body.
But too much can cause it to accumulate in the blood vessels, limiting blood flow to the heart, brain and the rest of the body.
This increases the risk of angina, heart attacks, stroke and blood clots.
Cholesterol is made in the liver and is carried by proteins in the blood.
The first – high-density lipoprotein (HDL) – carries cholesterol from cells to the liver where it is broken down or passed on as waste. This is & # 39; good cholesterol & # 39 ;.
& # 39; Bad cholesterol & # 39; – low density lipoprotein (LDL) – carries cholesterol to cells, with excessive amounts than in the vein walls.
High cholesterol can be genetic, but it is also linked to a diet rich in saturated fat, as well as smoking, diabetes, high blood pressure, and a family history of stroke or heart disease.
Blood cholesterol is measured in units called millimoles per liter of blood, often abbreviated to mmol / L.
The overall level of a healthy adult should be 5 mmol / L or less, while their LDL level should not be more than 3 mmol / L. An ideal level of HDL is more than 1 mmol / l.
Cholesterol can be reduced by following a healthy low-fat diet; do not smoke; and practice regularly.
If these do not help, cholesterol-lowering medication such as statins may be prescribed.
In the medical journal Heart in the Heart, the research team said: & # 39; There is currently no management strategy in clinical practice that takes into account patient variations in [low density cholesterol] response and no guidelines for predictive screening before starting treatment with statins. & # 39;
In a linked editorial in the same magazine, Dr. Márcio Bittencourt of the Sao Paolo University Hospital in Brazil wrote that the number of poor people was "clearly alarming".
He said that doctors may be to blame for not giving sufficiently strong doses of the medication.
& # 39; Effective implementation of guidelines among healthcare providers and the general population has long been a challenge & # 39 ;, Dr. Bittencourt wrote.
& # 39; Both physicians and patients should be targets for approaches that aim to improve compliance with guidelines. & # 39; However, other doctors rejected the findings.
Professor Metin Avkiran, associate medical director at the British Heart Foundation, said: “Statins are an important and proven treatment for lowering cholesterol and reducing the risk of a potentially fatal heart attack or stroke.
& # 39; Although this study suggests that not everyone prescribed statins is able to lower their cholesterol enough, it does not explain why.
& # 39; If you have been prescribed statins, you should continue to take them regularly as prescribed. & # 39;
Professor Kevin McConway of the Open University added: “Even if the difference in risk is caused by the difference in response to statins, this study cannot clarify what to do about it.
& # 39; The current guidelines set a goal for the extent of the reduction in LDL cholesterol that doctors should aim for, but it is less clear what they should do if that goal is not achieved. & # 39;
Professor Kausik Ray of Imperial College London, said: & The only conclusion is that a large proportion of people do not make guidelines-based recommendations.
& # 39; I don't agree, this is genetic variation and testing is needed.
& # 39; What is needed is that doctors prescribe the correct doses and that patients are informed about therapy compliance. & # 39;
Professor Helen Stokes-Lampard, president of the Royal College of GPs, added: & # 39; We want to encourage anyone who uses medication regularly to attend their scheduled medication reviews and to resolve any questions or concerns they may have. & # 39;
WHY ARE STATES CONTROVERSIAL?
Statins are the most prescribed drug in the world and an estimated 30 percent of all adults over 40 are eligible to take them.
The cholesterol-lowering drugs are given to people who believe they have a 10 percent or higher risk of developing cardiovascular disease or having a heart attack or stroke within the next 10 years.
They have been proven to help people who have had heart problems in the past, but experts say the thresholds may be too high, meaning that for many people the benefits do not outweigh the side effects.
Almost all men exceed the 10 percent threshold at the age of 65, and all women do so at the age of 70 – regardless of their health.
Commonly reported side effects are headache, muscle aches and nausea, and statins can also increase the risk of developing type 2 diabetes, hepatitis, pancreatitis, and vision problems or memory loss.
Research published in the Pharmaceutical Journal last year found taking a daily statin for five years after a heart attack prolongs your life by just four days, new research reveals.
And dr. Rita Redberg, professor at the University of California, San Francisco told CNN in January that 100 people take statins for five years without having had a heart attack or stroke, & the best estimates are that one or two people will have a heart avoid attack, and no one will live longer by taking statins. & # 39;