One of Northern Ireland’s top heart experts today welcomed the results of an international drug trial which supports his call for statins to be used on generally healthy people to drive down rates of heart attack and stroke.
Professor Mahendra Varma has so much confidence in the power of statins in tackling heart disease he once called for them to be put in Northern Ireland's water supply.
The Fermanagh consultant cardiologist has long believed everyone should be taking a statin as a preventative measure to keep cholesterol levels down — something he says would lower our devastating rates of heart disease and stroke, two of Northern Ireland’s biggest killers.
Statins are the biggest-selling drugs in the world — billed as the ‘miracle drugs' of the 21st century. They are a group of drugs commonly used to reduce cholesterol in people at moderate to high risk of a cardiovascular event and include the names atorvastatin, fluvastatin, pravastatin, rosuvastatin, and simvastatin.
Professor Varma, who is chairman of the Northern Ireland Chest, Heart and Stroke Association, said he welcomed the results of a new study of 17,800 men and women with normal cholesterol levels which found rosuvastatin cut deaths from heart attacks and strokes.
Published in the New England Journal of Medicine, the patients in the trial, funded by AstraZeneca, had cholesterol levels below those usually indicating a need for treatment and had no other signs of heart disease.
But they did have increased levels of a C-reactive protein, which indicates inflammation in the body and is believed to be a marker of future cardiovascular events.
After an average follow-up of two years, 20mg a day of rosuvastatin was found to have cut cholesterol by 50% and C-reactive protein by 37%.
Overall, the chance of a heart attack, stroke, hospital admission for chest pain or death from cardiovascular disease was cut by 44%, researchers said. A reduction was even seen in those with the lowest chance of a cardiovascular event over the next decade, they said.
The UK's National Institute of Clinical and Health Excellence (NICE) recommends doctors carry out a risk calculation based on an individual's blood pressure, cholesterol, weight and other risk factors, such as whether or not they smoke.
Referring to call for Nice to review its statin guidance in light of the study, Professor Varma said GPs should use their own discretion when prescribing a statin.
“Nice guidelines are not laid in tablets of stone and a doctor has the clinical freedom to look at the patient in a holistic manner, taking into account any family history of heart disease, and decide who could benefit from a statin,” he said.
“We at the Northern Ireland Chest, Heart and Stroke Association feel very strongly that cholesterol in all patients should be checked at least once a year.
“I have long been advocating the use of statins on a large and wide basis.”
Dr Terry McCormack, a GP in Yorkshire, and ex-chairman of the Primary Care Cardiovascular Society, said the results were “astonishing” and stronger than he would have expected.
He added that Nice should redo its cost-effectiveness calculation on the basis of the latest figures.
Nice is due to consult on plans to review its statin guidance shortly.