November 24, 2016

expert reaction to article about statins

An article published in the journal Prescriber has argued that the benefits and harms of statins may not have been accurately reported.

Prof. Sir Nilesh Samani, Medical Director at the BHF, said:

“This paper combines data and opinion that risks confusing patients about the benefits and safety of their statins.

“The evidence from numerous independent clinical trials going back more than two decades shows that statins are an effective way of people reducing their risk of a heart attack. The benefits are even greater for those who have already suffered a serious cardiovascular event.

“The main area of debate relates to the question of who should be given statins amongst those that have not yet had a cardiovascular event. This judgment needs to be discussed and agreed by patients and their doctors and the Lancet paper was an attempt to help this process. In the meantime, it is imperative that patients who have been prescribed statins, especially after a cardiovascular event, continue to take them and if they have any concerns to talk to their doctor.”

Prof. Mark Baker, Director of the Centre for Guidelines at NICE, said:

“NICE’s guidance on the risk assessment and reduction of heart disease and strokes, including lipid modification, is based on the overwhelming body of evidence supporting the use of statins, even in people at relatively low risk.

“The NICE guideline does not impose statins on everyone with a 10% or greater risk of developing heart disease or having a stroke within 10 years; it recognises the importance of personal choice in determining what measures are appropriate for preventing these. Our guidance says that due to a drop in the price of statins, these drugs are now cost effective at a lower clinical threshold. Decisions about whether patients should start or continue statin treatment should be made by the patient with their doctor.

“The effectiveness of statins is now well proven, as is their long term safety, and they are relatively cheap. To make progress in the battle against heart disease and stroke we must encourage exercise, improve our diets still further, stop smoking, and where appropriate offer statins to people at risk.”

‘More clarity needed on the true benefits and risks of statins’ by A. Malhotra et al. published in Prescriber on Thursday 24 November 2016.