Doctors to consider statins for up to 12m Britons

Up to 12m Britons - or one in four adults - could be prescribed cholesterol-lowering statin drugs to ward off possible heart attacks and strokes, under guidance to doctors issued on Friday by the National Institute for Health and Care Excellence (Nice).

Nice has halved the threshold for being offered treatment - from a 20 per cent risk of developing cardiovascular disease in the next 10 years, to a 10 per cent risk.

It suggests that doctors must consider many more people to be in danger than previous estimates have suggested. Cardiovascular disease is responsible for one in three deaths in the UK each year, or a total of 180,000 people.

The advice is likely to reignite a debate over whether the benefits outweigh the risks of taking the drug, which has been under way since February, when Nice suggested widening the criteria for prescribing statins. Several prominent clinicians wrote to Jeremy Hunt, the health secretary, to accuse some Nice advisers of being too close to the pharmaceutical industry.

Nice makes clear that, before opting for drug treatment, attempts should be made to tackle lifestyle issues such as smoking, diet, alcohol consumption and exercise.

However, it points out that some factors that put people at risk - including their age, sex, ethnicity and family history - cannot be altered and need instead to be "managed".

Professor Mark Baker, director of the Nice centre for clinical practice, said: "The weight of evidence clearly shows statins are safe and clinically and cost effective for use in people with a 10 per cent risk of CVD [cardiovascular disease] over 10 years."

Not everyone with a 10 per cent or greater risk would decide to take statins, he made clear. "The guideline recognises the importance of choice in preventing CVD and that this should be guided by information on the trade-off between benefits and risks," added Prof Baker.

Liz Clark, a lay member of the group that developed the guidelines, said a key challenge was "how to convince people who feel well that they need to make substantial lifestyle changes or that they benefit from life-long drug treatment".

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