Under Australian prescribing guidelines, a class of drugs known as statins are only available to people with High cholesterol.
However, an Australian and British study of more than 90,000 people has found statins can prevent heart disease in many more people, including those with low cholesterol.
Researchers from the Medical Research Council in Oxford and the University of Sydney and National Health and Medical Research Council in Australia found that taking statins daily can reduce the risk of Heart Attack and Stroke by about a third.
“This study shows that statin drugs could be beneficial in a much wider range of patients than is currently considered for treatment,” said Anthony Keech, deputy director of the NHMRC Clinical Trials Centre.
“In Australia the guidelines allow us to prescribe statins for most patients with Heart disease, but only if their cholesterol is greater than four.
“But even people with below average cholesterol levels can develop heart disease.
“This study calls for a review of those guidelines.”
Professor Keech said statins, which inhibit the synthesis of cholesterol in the liver, should be available to all patients with several risk factors for heart disease. “Other risk factors that should be considered include whether someone is a smoker, whether they have a family history of vascular disease, their age and their blood pressure, not just their cholesterol.”
The study, funded in Australia by the NHMRC and the Heart Foundation, found that lowering the level of ‘bad’ LDL cholesterol with a statin could reduce the risk of a Heart Attack or Stroke by at least one third. In Britain, low doses of some statins are available over the counter, unlike Australia where patients require a prescription. More than 14 million prescriptions for statins were issued in Australia in the 12 months to June last year.
Professor Keech said regulators should broaden the prescribing guidelines or make the drugs available over the counter.
“I think it (over-the-counter sales) certainly should be considered here,” he said.
“Better yet, it would be good to see this report used in the next review of the PBS, in terms of looking at access to statin drugs.”
The study also dispelled previous concerns that statins may increase the risk of some cancers or cause muscular problems.
“There is absolutely no evidence of increased cancer, any form of cancer, in patients taking statins for an average of five years,” he said.
“The muscle inflammation is extremely rare, it was only in a handful of people within the 90,000.”
Philip Barter, director of the Heart Research Institute in Sydney, said the evidence supported wider use of statins.
“Of all drugs that I am aware of, statins have the best safety record of any class of drug.”
Revision date: July 3, 2011
Last revised: by Jorge P. Ribeiro, MD