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Cholesterol-lowering drugs should be offered to all men over 50 and women over 60 as an effective “shortcut” to prevent heart disease, a government adviser has proposed.
Roger Boyle, the national director for heart disease and stroke, said that a “blanket approach” to give everyone above a certain age a daily dose of statins would save lives, NHS funding and doctors’ time.
The drugs, taken by an estimated 3 million Britons to tackle high chloresterol, could in future be given in combination with aspirin, folic acid and blood-pressure drugs as an all-in-one “polypill” to prevent heart-related death, Professor Boyle said. He added, however, that the public was not ready for mass medication that would mean millions of people being prescribed the drugs as a preventative measure even in the absence of any symptoms.
Heart disease is Britain’s biggest killer, accounting for one in three deaths. The annual cost to the economy is estimated to be about £26 billion a year, the bulk of which is treatment costs.
Patients as young as 30 who are at particular risk of heart disease could be prescribed statins for the rest of their lives under plans to expand screening for the condition. An estimated 100,000 people are thought to have abnormally high cholesterol owing to a defect inherited from their parents, but about 85,000 of those remain unaware of it, experts say.
Last month the National Institute for Health and Clinical Excellence (Nice) published draft guidance stating that millions of people should be assessed to find out how many more would benefit from taking statins. Information routinely collected by GPs could be used to identify those most at risk of cardiovascular disease and to prioritise them for further tests, the watchdog said. Adults who have a 20 per cent or greater risk of developing heart disease over the next decade should be offered statins, it said.
Such a move would double the number of people taking the drug on prescription to about 6 million, which would bring the total cost of the drugs to more than £1 billion a year. Last year the cost of prescribing the drugs was about £550 million. Final guidance from Nice is expected in January.
Statins, which include the brands Zocor, Lipitor and Crestor, have been hailed as a wonder drug since coming into widespread use in the 1990s. They work by reducing levels of low-density lipoprotein, the “bad” form of cholesterol, and are estimated to prevent up to 10,000 deaths a year. Although the drugs have been associated with liver problems, muscle wasting and a slightly elevated risk of cancer, the British Heart Foundation and the Department of Health say that the benefits outweigh any side-effects.
Professor Boyle said at a briefing in London that a person’s risk could simply be determined by an age threshold, about 50 or 55 for men and 60 or 65 for women. In 2003 a team of scientists claimed that such a pill could cut the risk of having a heart attack or a stroke by 80 per cent if taken daily by everyone over 55.
Nick Wald, from the Wolfson Institute of Preventive Medicine, said that polypills could prevent up to 200,000 premature deaths in Britain each year. It is being tested in countries including New Zealand and Spain.
Professor Boyle said that he did not believe that the public were ready to have everyone taking a daily pill with the aim of preventing future heart attacks. “I don’t think the general public is ready for the blanket approach where you get to 50 and start taking a pill,” he said. “I think we also are conscious of the accusation of being a nanny state and imposing things on people, so I think choice remains an important thing.”
Peter Weissberg, the medical director of the British Heart Foundation, said that a polypill containing several active ingredients could make it difficult to know what was causing any resulting side-effects. He said that he was not in favour of offering the drugs to everybody over a certain age. “Maybe in ten years’ time when we have more data on statins,” he said.
A spokeswoman for the Department of Health said: “There is currently no move to change from the individual assessment system that the NHS uses to a blanket approach.”

Common killer
— Cardiovascular disease (CVD), including heart disease and strokes, is the main cause of death in Britain, claiming 208,000 lives a year
— 48 per cent of those deaths are from coronary heart disease, which kills one in five men and one in six women
— 28 per cent are from strokes
— Every year 91,000 men under 75 and 31,000 women suffer heart attacks in Britain
— Death rates from CVD for the under75s have fallen by 24 per cent in the past ten years but are relatively high compared with other countries
Source: British Heart Foundation
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Cholesterol has as much relevance to chronic heart disease (CHD)as tyre skid marks have to traffic accidents. They are both present but are not the cause.
Where statins have worked it was most likely due to their properties as an anti inflammatory agent. This, of course, could be more cheaply and effectively provided by other medicines/supplements.
The real question is - what causes CHD and how do you prevent it? Given that inflamation of the arteries may be at the root of it all how about the prevention of this cause?. Factors adversely affecting it include stress, obesity, lack of vital elements, excess alcohol , smoking etc.
If you really want an opinion other than those gleaned from the manufacturer's press releases go on the internet and do a search on "Cholesterol Myths" . You will find a wealth of well researched analysis of all the major statin drug trials presented without the spin of the manufacturers.
2 authors worth checking are Dr Uffe Ravnskov and Anthony Colpo.
A Diver, Church Stretton, Shrops
Can we just check Roger Boyle's bank balance for payments from the Statin manufacturers before we go any further?
Thalia, London,
Considering the toxic side-effects of statins and the likely rebound effect of increasing cholesterol on stopping the drug, it is an infinitely better choice to simply take vitamin E, 400iu daily, which according to the Addenbrooke study of 1996 was able to reduce heart attack risk by almost 80%. No drug can equal this level of benefit - so why is this simple measure not being used more widely? Statins are also being advised for the treatment of multiple sclerosis but I have found it to be ineffective for this purpose, partly because it blocks the action of co-enzyme Q10, thus increasing fatigue and other symptoms.
Dr Bob Lawrence, Swansea, UK
What will happen to blood donating, if all are not allow to donate if they take the relevant drugs,
Anthony, Ealing London
Phillips, London,
II have been taking statins for the past 5 years and it seems that I am allergic to all the many brands I have taken. Infact the last trial of a statins had taken away the good Cholesterol and left me with the bad Cholesterol.
I had a triple bypass 5 years ago and since then have been taking the statins. My cholesterol without statins is about 7.5 with them it is brought down to 4.5 but the side effects are rather drastic.
1/ I have put on about 4 stone
2/ My joints Ache but Glucosmine Sulphate has helped
3/ My liver was close to being damaged with a certain type
But above all I am still here and feeling ok, my quality of life good, better the statins than an early death. I am sure that without them I would now be a very sick man.
Even at 65 I have just taken up full time employment, thank god I can work with the help of statins because my quality of life is now enhanced meeting young vibrant people with the bonus of some money in the bank.
Peter Canacott
Peter Canacott, Crawley, West Sussex
Blanket prescriptions must be bad medecine. We are all very different; and when we see how often even our own doctors are wrong about us the idea that some bureacrat deus ex machina is going to get it right is laughable.
I was given statins, but my muscles tore and I couldn't walk. Nothing could be worse than that, nor more unhealthy. I gave them up immediately and have lived happily ever since. Particularly since reading that a square of dark chocolate after every meal will keep down blood pressure- provided of course that one follows a sensible diet. As the fellow who jumped out of the Empire State Building said, passing the hundredth floor: all well so far! We are all going to end up on the pavement sooner or later; not even these clever doctors have yet discovered anti-gravity!
Robert Sebag-Montefiore, Geneva, Switzerland
How long before we are on compulsory prozac? Is this for drug company profits or to prolong tha agonies of the fag end of life in this hell hole.
Christopher, Cheltenham, Glos
Though statins may be effective, they should not be forced upon people.
My moher has been advised to take them for medical reasons, however she is reluctant to as they have quite strong side-effects.
Marios Patrinos, Reading, UK
to be honest statins is one of the most de humanising drugs that is out there the side effects is demeaning and has a physchological effect this drug has not been properly refined as to why it causes such lethargic feelings in one.
t gray , glasgow,
The central premise of Professor Boyle's thoughts shows flawed understanding of both his fellow humans and his role as a leader.
Grateful most will be for the availablility of medication should they have its need. And for helpful advice on how best to remain healthy. These acts would be facilitative.
But usurping self discretion from people who have developed an understanding of themselves over their lifetime? This would be dictatorship and emaciating of people's character.
Re-think ot re-sign fella.
John Jacobs, London, Ontario / Canada
I am a non smoking active 60 year old, 5ft 7 tall, weigh under 9 stone with normal blood pressure who, following a routine once a year blood test, have just been prescribed statins by my Dr here in France. My husband has taken them for several years and we do follow a very non French low fat diet with plenty of fruit and vegetables, pulses and porridge. In fact all of my husbands results fall within the normal range, which our Dr congratulated him on, and believe me there are an impressive variety of tests covered in this state health service check up. I questioned why I would have cholesterol problems given our attention to diet and was told it is far from bizarre as I suggested because not all cases are caused by diet.
So all you doubters take note, and do stop being so daft ... blanket prescribing is not the same as forcing the stuff down your throat. You would have the choice of not collecting your prescription lol.
Susan, Montpellier, France.
I was on a statin for about 5 years and believed the next wonder drug had arrived! My cholesterol levels dropped like a stone. The side effects were so subtle I never put them down to the statin, just my age, I am over 60 years after all.
I searched the internet and discovered a vast number of people suffering serious side effects like me and worse. I have been 'statin free' since last March and feel a new man. Still got a way to go and some side effects may never go away but I'm now sure that my Cholesterol levels will do me no harm so long as I live a healthy life style and exercise moderately.
I went to my doctor a healthy man who just wished to have a check up and was advised to take a drug called a 'statin' which would help prevent Heart disease.
Put every man over 50 years of age on 'statins'...you must be joking !
Tom Murdock, WATERFORD, IRELAND
A one-size-fits-all approach to mass medication with risk levels determined by age seems an inherently hit-or-miss approach to individual lives, if not a potentially dangerous tool within a unified patient information system under government control.
If one object were to reduce future cost to the NHS of heart disease one may wonder at the logic of treating, in advance, possible consequences of excessive eating of an
unbalanced diet with insufficient physical activity, when it would be less costly and more safe to deal directly with the causes.
dr venables preller, Warminster, UK
Statin drugs cause degenerative failure of short term memory.
They do not prevent heart disease, no matter how many distorted statistics say they do. We live in a society that does not act for our benefit, whoever recommended a blanket prescription of statins did so deliberately to harm us, and they must be brought to account by independent studies that expose these lies.
Tony, London,
This is terrible. I dont want to be made to take pills once I reach a certain age if I dont need them. Whatever is wrong with leading a normal life independent of medication and letting your body deal with things naturally where possible. Surely we have a right to put in our bodies what we want. If we are healthy why take drugs with potential side affects affecting our general well being. And side affects aside I dont want to become a chemical repository for do good doctors and pharmaceutical companies after a fast buck.
pat, medway, kent
Didn't I read somewhere that statins sometimes make people ill? Mass prescribing is nonsense.
Ian, Bristol,
An excellent article that everyone above 50 in the country should read and benefit from.
R.K.Raghavan, London, UK
I have drastically modified my diet and exercise regularly, do not smoke and am not over weight. However both my parents died in their mid fifties, yet there is nothing I can do about hereditary factors. Therefore any extra help I can get would be surely beneficial.
Linda Jensen, Mersyside,
It is bad enough that medical profession in this country does not acknowledge the existence of low blood pressure. Now the drugs are meant to lower it even further! What are we with low blood pressure to do? Emigrate?
Lilly Evans, Virginia Water, Surrey
This 'one size fits all' idea of health care is madness. I have no doubt that it would reduce heart disease deaths but what about the medicalisation of the "virtuous" - millions with normal / low cholesterol, weight and blood pressure who have chosen modifications to diet and lifestyle rather than the drug route? I'm four years away from the date Professor Boyle suggests starting statins but all my 'numbers' are fine thanks to hard exercise and a decent diet. How many of the millions of healthy would say 'sod it' and just take the pills? Sounds like a recipe to pass an even greater proportion of the UK's GDP to the drug multinationals and a dozen company directorships for the people who made it happen.
Paolo Bagarino, Roma, Italia
That's right, dose everyone up until you find out that the medication is worse for you than the cholesterol was. Then give lawyers millions of pounds to administer £3.50 compensation. I think we've been here before.
Judy , Liverpool, england
I wonder how many of the people at risk of CVD have thought of modifying their diet and lifestyle. For example, for some years now, one of my regular breakfast choices has been a homemade vegetable soupt, with 50 grams of shredded cabbage, plus carrot, onion and celery, flavoursed with half a vegetable stock cube. Eaten with a slice of homemade, whole wheat bread, this makes a delicious meal to start the day. I also reckon to walk for about an hour day, and at 67 still feel in the very best of health.
akai ringo, Tokyo,