Statin therapy has received another boost - this time from a report in the British Medical Journal claiming the cholesterol-lowering drugs are seriously under-used.
Analysis of data on over 20,000 people found that the drugs could benefit both younger people and people less as risk of heart attack than current guidelines suggest.
The Oxford Unversity team found that statin treatment was cost effective in people as young as 35 and as old as 85 with an annual risk of a major vascular event as low as 1%.
This is well below the risk threshold currently recommended by the National Institute for Health and Clinical Excellence (NICE).
Large trials have shown that lowering blood cholesterol levels with statins greatly reduces major vascular events, such as heart attacks and strokes, in people at high risk.
And research published in 2005 from the largest of those trials (the Heart Protection Study) showed that when cheaper generic versions are used, several years of statin treatment is cost effective for a wide range of people with vascular disease or diabetes.
The Heart Protection Study involved 20,536 men and women presenting at age 40-80 with heart disease or diabetes. They were randomly allocated to receive either 40 mg simvastatin daily or placebo for an average of five years.
Using data from this study, the Oxford researchers have now estimated the lifetime cost effectiveness of 40 mg of simvastatin daily for people in an even wider range of age and underlying vascular risk categories.
The research team found that treatment with generic simvastatin would be cost saving for most of the age and risk categories included in the heart protection study.
In other words, the reduced costs of hospital admissions as a result of fewer vascular events outweighed the increased costs of statin treatment in almost all of the categories studied.
Oxford Unversity health economist Dr Borislava Mihaylova, said: “Clearly these drugs are cost effect for this larger group of people as well. There are currently two million people on statins. It could be that millions more would benefit.”
Professor Peter Weissberg, Medical Director at the British Heart Foundation, said: This analysis suggests that through the health benefits that simvastatin offers, it is cost effective to offer the treatment to many more people than are currently considered eligible.
He added: “However, of even more importance is the need to ensure that everyone at very high risk gets the treatment they need.”