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Tuesday, 27 September 2005 10:15
BNN: British Nursing News Online · www.bnn-online.co.uk
Thousands dying from drug restriction
A University of Oxford study has found that the wider prescription of life-saving statin drugs could save thousands of lives.

The availability of cholesterol lowering statins, which reduce the risk of heart attack and stroke, is restricted to people suffering from high cholesterol.

However, researchers found that many more patients with diseased arteries could have their risk of heart attack and stroke reduced by one third by taking a big enough dose of the drug.

Colin Baigent, who led the study, said: "There aren't many drugs that can do that. Given a decent dose, statins are wonder drugs. [But] they are being used in a less than efficient way. What we have found is that if you are at high risk of a heart attack or stroke, reducing your cholesterol, regardless of its current level, will reduce your risk.'

"Many doctors use target levels for cholesterol. If you have an average cholesterol level you might get no statin or a low dose. Of those who are being treated with statins at least half are not getting a high enough dose.

"What matters most is that doctors identify all patients at risk of a heart attack or stroke, largely ignoring their blood cholesterol level, then prescribe a statin at a daily dose that reduces their cholesterol substantially. The goal of treatment should be to reduce cholesterol as much as possible. There is a problem of under-treatment."

The study, involving 14 randomised trials of 90,000 patients, found the risk of heart attack or stroke was reduced by a fifth for every 1mmol reduction in the patient’s low density lipoprotein (LDL) cholesterol level.

With appropriate use of statins, most patients reduced their cholesterol level by at least 1.5mmols, achieving a one third reduction in risk.

Researchers also found no evidence of increased incidence of cancer or depression leading to suicide, both of which have raised concerns among doctors in the past.

Professor Anthony Keech of the University of Sydney, said: "Statins are often prescribed in relatively small doses which may only reduce cholesterol modestly. Our results indicate that the benefits of statins appear directly proportional to the size of the reduction in cholesterol produced by treatment. So, bigger cholesterol reductions with more intensive treatment regimens should lead to greater benefits."


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