Statins: a preventative treatment for cardiovascular disease (CVD)
MEDICINES & TREATMENTSHEALTH CONDITIONSHIGH CHOLESTEROL
New updated recommend prescribing statins for primary prevention of CVD. Statins are a class of drugs used to lower high cholesterol in the blood. By doing so, it decreases the risk of getting the formation of blood clots, which may lead to life-threatening conditions such as stroke, angina, myocardial infarction or peripheral arterial disease.
Statins are a class of medication used to treat hypercholesterolemia (a health condition characterised by high cholesterol). Some examples of statins include: simvastatin, atorvastatin, pravastatin, rosuvastatin. They work by inhibiting an enzyme named HMG CoA enzyme which is involved in cholesterol synthesis in the liver. By blocking the action of this enzyme, this reduces the formation of the cholesterol, hence reducing its levels.
Just recently a new guideline was added stating that statins can be prescribed for primary intervention of hypecholesterolemia in patients at a high risk of first cardiovascular event. [1]
Up until now the statins were prescribed for patients with a 10% or higher risk over 10 years of a cardiovascular event according to the NICE guidelines. [2]
However, now the new guideline recommends that statins can be considered as part of shared decision-making for patients who haven’t had a cardiovascular (CVD) event (called ‘primary prevention’) with a 10-year CVD risk score 10% or less. The NICE committee agreed that if more people took statins there would be a greater reduction in the incidence of heart disease and strokes. [2]
Although statins are known to cause side effects such as myopathy or muscle pains particularly, some evidences actually show that there isn't a strong connection between taking statins and muscle pains.[3] It is considered to be a not common side effect considering that only 5 cases per 100000 people might have it. Hence, the benefit surpasses the side effects in this case.
The new guideline recommends that doctors can consider prescribing atorvastatin 20 mg for the primary prevention of CVD for patients with a 10-year risk of less than 10% where the patient is happy to take a statin. If the patient declines the treatment with a statin, then they might need to be reassessed again at a later date for any CVD risk. [2]
Cardiovascular disease is one of the most common cause of death worldwide, and high cholesterol is a significant risk factor for it. It is responsible for the cause of ischemic heart disease which occurs when the blood vessels supplying the heart are narrowed or blocked, leading to disruptive supply of oxygen to the tissues. In England, high cholesterol leads to over 7% of all deaths and affects up to 60% of adults. [4]
People can be at risk from CVD because of factors they cannot change including their age, sex, ethnicity and family history. It is recommended that risk factors which can be solved should be managed. These include stopping smoking, reducing alcohol consumption, taking exercise and eating a healthy diet.