Give three quarters of men statins for 90 pc benefit

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The Pharmaceutical Journal
Vol 276 No 7402 p617
27 May 2006

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Give three quarters of men statins for 90 pc benefit

A comparison of UK, European and US recommendations for use of statins in the primary prevention of vascular disease reveals that over three quarters of adult men need to be treated to gain maximum population benefit.

Researchers from Manchester Royal Infirmary fed data from a cohort of 1,653 men, who had 212 heart attacks or strokes between them over 10 years, into computer programs to determine the proportion of men who would be judged to be at risk from cardiovascular disease and those who would be treated with statin therapy under several published guidelines.

The researchers calculated that if all men had received statin therapy, around 64 heart attacks or strokes would have been prevented. When the recommendations set out in the guidelines were applied, however, differences in outcome were predicted.

Guidelines tested

· National Service Framework for CHD

· Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice

· US National Cholesterol Education Program Adult Treatment Panel III

· First Joint British Societies guideline

· Fourth British Hypertension Society and second JBS guidelines

Of the guidelines tested (see Panel above), recommendations set out in the National Service Framework for Coronary Heart Disease targeted those at highest risk and had the lowest preventive impact (14 per cent of the men were judged to need statin treatment, which would have prevented just over 19 of the 212 events). The US recommendations and an early Joint British Societies guideline would have prevented more events (between 45 and 50) with about 60 per cent of the population being treated. The greatest population impact was achieved by the British Hypertension Society guideline and newer JBS recommendations, which prevented around 57 events with about 77 per cent of the population being treated (published online Heart Online First, 22 May 2006).

Estimated CVD costs Cardiovascular disease costs the UK £29bn a year, an analysis published online suggests (Heart Online First, 15 May 2006). Health economists estimated costs of CVD in 2004 from expenditure on community health and social services, accident and emergency care, hospital care, rehabilitation, drugs, informal care and from productivity losses arising from morbidity and premature death.