The majority of patients at high risk of cardiovascular disease are not being started on statin therapy, suggests new research published in the British Journal of General Practice.
NICE guidelines state that GPs should use a 10-year cardiovascular (CVD) risk estimate to determine whether patients should be started on statins.
But researchers from the University of Birmingham, who looked at records of over 1.4 million patients aged over 40 years, found that only just over 10 percent had a recorded CVD risk score and that 15 percent had been started on statins since 2012.
Only around a quarter of these newly-treated patients had a record of a risk assessment recorded within their notes. Just 35 percent of patients at high-risk of CVD had been initiated on a statin, while one in six patients were in the low-risk category and should not have been offered a statin according to NICE guidelines, the findings show.
The study suggests that patients at high risk of CVD are being undertreated, and the researchers stress that all patients should have a documented 10-year risk score before statin initiation to ensure that treatment is appropriate.
However, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said the study “simplifies the true situation because it does not include any information about individual patient preferences, other health conditions, or data that was not accurately coded in patient records.”
But she did agree that it “emphasises the importance of calculating an accurate risk score which can then help healthcare professionals have an honest discussion with their patients about the benefits and risks which are unique to them.
"As with any drug, taking statin medication has potential side-effects, and taking any medication long-term is a substantial undertaking for patients who need to be monitored by healthcare professionals. Many don't want to take statins once they have learned all the facts – and GPs will respect patient choice.”
Statins reduce level of bad cholesterol in the blood and are prescribed to prevent heart attacks and strokes, yet patients are often reluctant to taken them because of controversy over their safety and efficacy. However, according to a major review published in The Lancet last year, benefits of statin therapy have been underestimated and harms exaggerated.