Millions more people at future risk of heart attack and stroke could be offered access to cholesterol-busting drugs under fresh NHS guidance.
The National Institute for Health and Care Excellence (NICE) has lowered the eligibility threshold for patients being offered statins, based on evidence suggesting the benefits.
Until now people with a 10% or higher risk over 10 years of suffering a cardiovascular event – such as a heart attack or stroke – are routinely prescribed the medication to combat the chances of becoming ill.
NICE is suggesting doctors continue to persuade people with a lower risk to live a healthier lifestyle, such as losing weight or stopping smoking.
But, if after this a statin is still considered an appropriate option, one can be prescribed.
NICE estimates there are around 15 million people in England aged 25 to 84 with a 10-year risk up to 10%, though it says people must have a degree of risk to receive a statin.
Data indicates that for every 1,000 people with a risk of 5% over the next 10 years who take a statin, about 20 people will not get heart disease or have a stroke because they take the pill.
This figure doubles to 40 for people with a risk of 10%, and for people with a risk of 20%, NICE estimates that, on average, around 70 people would not get heart disease or have a stroke in the next 10 years.
However, the official risk level at which statins should routinely be offered will remain at 10%.
Paul Chrisp, director of the centre for guidelines at NICE, said: “What we’re saying is that for people with a less than 10% risk over 10 years of a first heart attack or stroke, the decision to take a statin should be left to individual patients after an informed discussion of benefits and risks.
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“The evidence is clear, in our view, that for people with a risk of 10% or less over 10 years, statins are an appropriate choice to reduce that risk.”
He added: “We are not advocating that statins are used alone. The draft guideline continues to say that it is only if lifestyle changes on their own are not sufficient, and that other risk factors such as hypertension (high blood pressure) are also managed, that people who are still at risk can be offered the opportunity to use a statin, if they want to.
“They don’t have to, and their decision should be informed by an understanding of the risks and tailored to their values and priorities.
“It may well be that many people will say that they are happy to accept a risk of having a heart attack or stroke rather than taking statins every day – which is absolutely their prerogative.
“They just need to know and understand the level of risk.”
Naveed Sattar, professor of metabolic medicine at the University of Glasgow, said: “I agree statins are well proven to lower cardiovascular outcomes cost effectively at thresholds less than 10%, so this new guidance makes sense.
“However, we need also to concentrate more on helping people live healthier lives and not just longer with more diseases.”
He added: “More people on statins alone will not be enough to meaningfully improve the health of the nation.”
Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood.
LDL cholesterol is often referred to as “bad cholesterol” and is linked to cardiovascular disease, which can increase the chance of strokes and heart attacks, and death.
