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A major study suggests that half of people who are prescribed statins have a high risk of heart disease because the tablets can not lower their cholesterol levels.
Experts have advocated a much more appropriate approach to the use of statins as a result of "clearly alarming" findings.
The 165,400 study, led by the University of Nottingham, showed that 49% of patients taking the drugs did not see their cholesterol levels return to healthy levels in two years.
Researchers believe that this may be due to the genetic makeup of some people, making the pills ineffective, or to other drugs that they take, that interfere with the functioning of the statins.
Another theory, however, is that many people in the study may have simply stopped taking their statins, which is why they did not see any effects.
Statins are the most commonly prescribed medicine in the world and about 30% of adults over 40 years old have the right to take them (stock)
About six million Britons take cholesterol-free statins, avoiding 80,000 heart attacks and strokes each year, at a cost of about £ 20 per year per patient.
The drugs are designed to reduce the levels of "bad" LDL cholesterol in the blood, reduce the formation of furs in the arteries and reduce the risk of heart attacks and strokes.
But the new study, which used general practitioner records from patients across the UK, found that only half of the patients who received a statin prescription got the expected answer.
The researchers found that for 51% of patients, statins were incredibly effective – reducing cholesterol by at least 40% in two years.
But for the remaining 49%, there was no significant impact.
And patients who did not respond to pills were 22% more likely to develop cardiovascular disease than those who did.
The researchers admitted that the data only showed if each participant was prescribed statins – and not if they had actually taken it -. They urged patients not to stop taking their medications until more definitive results were obtained.
But Dr. Stephen Weng, head of the study, said, "We need to develop better ways to understand the differences between patients and to tailor more effective treatment to those millions of patients who are simply general statins.
"Our research has shown that in almost half of the patients, the prescribed statins are very effective and offer significant protection against cardiovascular disease.
"However, for the other half – whether because of your genetic makeup, your side effects, your treatment, or any other medication – we do not see the expected benefit."
WHAT IS HIGH CHOLESTEROL?
Cholesterol is a fatty substance essential to the normal functioning of the body.
But too much can cause buildup in the arteries, limiting blood flow to the heart, brain and the rest of the body.
This increases the risk of angina, heart attack, stroke and blood clots.
Cholesterol is made in the liver and is transported in the blood by proteins.
The first, high density lipoprotein (HDL), transports cholesterol from the cells to the liver where it is broken down or rejected. This is "good cholesterol".
"Bad cholesterol" – low-density lipoprotein (LDL) – transports cholesterol to cells, with excessive amounts developing in the walls of the arteries.
High cholesterol can be genetic, but it is also linked to a diet high in saturated fat, smoking, diabetes, hypertension and family history of stroke or heart disease .
Blood cholesterol is measured in units called millimoles per liter of blood, often abbreviated as mmol / L.
The overall level of a healthy adult should be 5 mmol / L or less, while its LDL level should not exceed 3 mmol / L. An ideal level of HDL is greater than 1 mmol / L.
Cholesterol can be reduced by eating a healthy, low-fat diet; no smoking; and exercise regularly.
If this does not help, cholesterol-lowering drugs such as statins may be prescribed.
Source: NHS
In the medical journal Heart, the research team said: "Currently, there is no management strategy in clinical practice that takes into account variations in the [low density cholesterol] response, and no recommendations for predictive screening prior to the start of statin therapy. & # 39;
Dr. Márcio Bittencourt, of Sao Paulo University Hospital, Brazil, wrote in a related editorial in the same newspaper that the number of poor responders was "clearly alarming".
He added that doctors could be held responsible for not administering sufficiently large doses of drugs.
"Effective implementation of guidelines among health practitioners and the general population is a long-standing challenge," Dr. Bittencourt wrote.
"Doctors and patients should be targets for approaches to improve compliance." Other doctors have however rejected the results.
Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, said, "Statins are an important and proven treatment for lowering cholesterol and reducing the risk of heart attack or potentially fatal stroke.
"Although this study suggests that not all people who have statins prescribed are able to reduce their cholesterol enough, that does not explain why.
"If statins have been prescribed to you, you must continue to take them regularly, as prescribed."
Professor Kevin McConway of the Open University added, "Although the difference in risk between risks is due to the difference in response to statins, this research does not clearly determine what needs to be done about it.
"The current guidelines provide a goal as to the extent of LDL cholesterol reduction that physicians should aim for, but it is less clear what they should do if this goal is not achieved." .
Professor Kausik Ray, of Imperial College London, said: "The only conclusion to remember is that a large number of people fail to make recommendations based on guidelines.
"I do not agree that there is genetic variation and that tests are needed.
"What is needed is that doctors prescribe the right doses and that patients be informed of the therapeutic observance".
Professor Helen Stokes-Lampard, President of the Royal College of GPs, added, "We encourage anyone who is taking regular medications to attend the scheduled medication review and to share any questions or concerns."
WHY STATINES ARE CONTROVERSIES?
Statins are the most commonly prescribed medicine in the world and it is estimated that 30% of all adults over 40 years old have the right to take them.
Cholesterol-lowering medications are given to people considered to be at least 10% risk of developing cardiovascular disease or having a heart attack or stroke in the next 10 years.
It has been proven that these drugs help people who have had heart problems, but experts believe that the thresholds may be too high, which means that the benefits are offset by the side effects for many people.
Almost all men are over the threshold of 10% at age 65, and all women at age 70, regardless of their health.
Commonly reported side effects are headache, muscle aches and nausea. Statins can also increase the risk of type 2 diabetes, hepatitis, pancreatitis and vision problems or memory loss.
A study published in the Pharmaceutical Journal last year found that taking a daily statin for five years after a heart attack prolongs your life by just four days, reveals a new study.
And Dr. Rita Redberg, a professor at the University of California at San Francisco, told CNN in January that out of 100 people taking statins for five years without having a heart attack or stroke, "the best estimate is that one or two people will avoid a heart attack, and none will live longer, taking statins.
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