Skip to main content

Three key issues in trying to increase the use of statins in the UK

Statistics from the OECD show that the per capita use of statins in the UK is the highest in Europe and the second highest in all OECD countries. There are a number of reasons for this, which include the emphasis on evidence-based medicine in the training of UK doctors; the 2004 GP contract which introduced incentives for the management of long-term conditions such as coronary heart disease and diabetes; and the NHS Health Check programme which aims (amongst its objectives) to increase the use of statins for the primary prevention of cardiovascular disease (CVD) in people with a 20% or more 10-year risk of CVD.

The National Institute for Health & Care Excellence (NICE) is now proposing to reduce the threshold for starting statins for the primary prevention of CVD from its current threshold of a 20% 10-year CVD risk to a 10% 10-year CVD risk. Although this could have significant benefits for the health of the population, there are three issues that need to be considered. These issues are: GP funding and workload, the willingness of people to take part in CVD primary prevention programmes; and the need for accurate information on the side-effects of statins.

The full-text of this blog can be read on the BMJ Blogs Site.

Comments

Anonymous said…
Anecdotal evidence cuts no ice, but I am personally interested in side effects. I have had three periods on two different statins over a couple of years. While taking them I have discomfort in both quads and feelings of weakness (including a couple of falls), and develop easy bruising of my hands. Blood tests have shown no abnormalities (save my modestly raised cholesterol). Within two weeks of stopping (on three occasions) the aches have gone and so have the bruises. So I have stopped statins and am going down to the local swimming pool to exercise instead. I do worry about the completeness of recording of side effects and am quite sure that my GP has not reported the ones that I have experienced. Let us hope that those denying the significance of side effects are proved right, or once more the profession will have done substantial harm to the population.

Popular posts from this blog

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...

UK Covid-19 Inquiry - The Importance of a Strong Primary Healthcare System

In my witness statement for Module 10 of the UK Covid-19 Inquiry, I discuss the pandemic's impact through from the perspectives of  primary care and public health, drawing on my extensive experience as a senior academic at Imperial College London and as a practising GP and NHS Public Health Specialist.  I emphasise that the pandemic disproportionately affected people who were clinically vulnerable, the disabled, ethnic minority communities and those living in deprived areas. The pandemic highlighted how structural inequalities, multigenerational housing, and employment in high-risk frontline roles exacerbated health disparities.  My statement also critiques the weakening of public health infrastructure - particularly for the control of infectious diseases - and the lack of integrated health data systems to identify at-risk groups such as the clinically vulnerable. I also advocated for a more robust preventive healthcare model that prioritises community-based primary care ...

Protecting Young People from Meningococcal B Disease: The NHS Targeted Vaccination Programme

Meningococcal group B (MenB) infections are rare but can have devastating consequences. The decision to offer a targeted two-dose vaccination programme to Year 13 students and young people entering university or residential further education reflects concerns about recent outbreaks of meningococcal disease and the higher risk of transmission when large numbers of young adults mix closely for the first time in shared accommodation. The MenB vaccine has a well-established safety record, and evidence from the UK infant immunisation programme has shown substantial reductions in disease among vaccinated children. A targeted programme for those entering higher-risk settings is therefore a reasonable precautionary measure while further evidence is gathered on whether the recent increase in clusters represents a temporary fluctuation in disease patterns or a more sustained change in the epidemiology of MenB infection. The success of the programme will depend on achieving high uptake and ensuri...