England's National Institute for Health and Care Excellence (NICE) has issued new draft guidelines for NHS doctors detailing which patients should be offered statins to prevent or delay heart attacks or strokes. These widen the patient pool which are recommended receive these drugs as a matter of course.
Statins reduce the production of low-density lipoprotein cholesterol (LDL) in the liver. High LDL levels are associated with heart attacks and strokes. Doctors use a calculator called the QRISK2 test. This is the model used for the UK however you should note that the UK postcode field - the equivalent of the US Zip+4 long code - is taken into account in the calculation (leaving it blank knocked 1.3% off my risk).
The QRISK2 uses various factors to calculate your risk of having a heart attack or stroke in the next 10 years. Previous guidelines recommended that doctors offer statins to all patients with a risk factor of greater than 20%. The new guidelines reduce this to 10%.
The use of statins by otherwise healthy people is controversial. Some side effects have been experienced in a few cases and liver function tests should be used to check the suitability of the patient and to make sure that function is not impaired by the drug. Other measures like weight loss, diet changes and exercise also reduce LDL levels. Anti-hypertension (high blood pressure) drugs should also be considered.
Bear in mind that NICE make their recommendations based on cost-benefit analyses. The NHS currently pays about £450 million (US$743 million) for statins based on the 20% risk. This is offset by the cost of treating patients who would otherwise have heart attacks or strokes within the 10 year window. Obviously the cost-benefit analysis using US costings may well indicate a different level where in purely financial terms statins are advised. This does not of course mean the non-financial benefits (better life expectancy!) should not be considered.
As with all such advice, check with your own doctor before buying off the shelf drugs - preventive medicine to reduce overall costs like this is what Obamacare is all about. Arm yourself with information in advance - a good starting point in the NHS patients' site which is about the best source of unbiased information on all sorts of conditions.