Medicines Management
Issue no 1, pp1-6
January/February 2002

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Community pharmacists "must spread the news about statins"

Community pharmacists could play an important role spreading the news about the cardioprotective effect of statins, a leading researcher has said.

Dr Jane Armitage, senior research fellow at the Clinical Trials Service Unit, Oxford University, said that in the wake of the Heart Protection Study patients needed to know about the potential benefits from being prescribed statins.

The CTSU reported the results from the Heart Protection Study early after their data showed not only a clear benefit among those taking simvastatin 40mg, but also that many more people would benefit from being prescribed the drug than previously thought.

Dr Armitage said: "This will require a whole shift in the way that people think about who will benefit from this drug. Up until now GPs have been asked to meet various targets for cholesterol, such as ensuring that total cholesterol concentrations are below 5mmol/L and LDL-cholesterol is below 3mmol/L. But patients in this trial with cholesterol concentrations below these targets also benefited from taking simvastatin."

The research recruited more than 20,000 individuals from 69 hospitals with various prior diseases, including coronary disease, other occlusive arterial disease, diabetes, and hypertension. People in categories in which the benefits of statin therapy were unclear were also recruited, such as women, the elderly and those with average or below average cholesterol levels.

Half of the participants were randomly allocated to receive 40mg daily, and half to receive placebo. Within each of these two groups half were allocated to receive antioxidant vitamins (600mg E, 250mg C and 20mg beta-carotene daily), and half to receive placebo capsules.

The study found that cholesterol-lowering with statin treatment reduced the risk of heart attacks and strokes by at least one-third, as well as reducing the need for arterial surgery, angioplasty and amputations.

"What the data would suggest is that whatever your cholesterol and however old you are you will still benefit from being on this drug," said Dr Armitage.

And she added that pharmacists could help to spread the message to patients. "One of the ways of getting the message out there is to inform patients, and pharmacists have a role to play in that. That is what happened with aspirin, and that is what we would like to happen with simvastatin."