NICE publishes guidance to widen statins treatment

Despite failing to win the backing by the British Medical Associatio, NICE has stuck to its decision to widen the number of patients eligible for statin treatment.
The decision by NICE (The National Institute for Health and Care Excellence) will see anyone with a 10% risk of heart disease in the next 10 years offered statin treatment. The guidelines will take effect immediately within England but will require signing off in Northern Ireland and Wales. NHS Scotland has proposed no plans to widen statin treatment however.
The guideline (clinical guideline 181) will mean the majority of people with diabetes in the UK will be offered statins, if they are not taking them already, and millions of people without diabetes will be offered statins as well. The guidelines note that people prescribed statins should receive annual medication reviews.
The decision to widen statin treatment is not without controversy. The General Practitioners Committee (GPC), part of the British Medical Associatio, has spoken out about its doubts over the new plans, stating: “There is insufficient evidence of significant overall benefit to low-risk individuals to allow GPs to have confidence in the recommendation.”
Within the medical community opinion is widely polarised over the regularity of side effects associated with statins. The new guidelines from NICE assume that there are very little side effects associated with statins, whilst a number of leading practitioners dispute this assumption. Amongst the leading health professionals that have called the new guidelines into question are Dr Clare Gerada, the former President of the Royal College of General Practitioners (RCGP) and Dr Kailash Chand, Deputy Chairman of the British Medical Association (BMA).
Whilst the NICE guidelines assume that side effects of statins are minimal, recently published research shows that adherence to statins increases the risk of type 2 diabetes by as much as a third.
The argument in favour of statins is based on the fact that for every 1,000 people taking statins over a three year period, there will be 2 fewer deaths, 4 fewer strokes, and 7 fewer non-fatal heart attacks.
Whilst statins will be offered to a much greater number of people, including those with diabetes, adherence is not mandatory and treatment should be agreed between patient and doctor. Prof Sir John Tooke, President of the Academy of Medical Sciences, states: “Whether or not someone takes drugs to diminish their risk is a matter of personal choice, but it must be informed by accurate information on the balance of risk and benefit in their particular case.”