Only Half on Statins See 'Appropriate' Reduction in Bad Cholesterol

Many patients on statins do not see their cholesterol drop to target levels research suggests

Many patients on statins do not see their cholesterol drop to target levels research suggests

Half of all people who are prescribed statins for the prevention of heart disease fail to reach target cholesterol levels two years later, according to a new study.

National US and United Kingdom guidelines created to curb cardiovascular disease deaths specify statin treatment targets: in the United Kingdom, the National Institute for Health and Care Excellence (NICE) stipulates a reduction of 40 per cent or more in LDL ('bad') cholesterol.

"Bad" low-density lipoprotein (LDL) cholesterol is a major contributor - it can lead to furring and blockage of blood vessels.

"Although this study suggests that not everyone who is prescribed statins manages to reduce their cholesterol sufficiently, it doesn't explain why".

"Currently, there is no management strategy in clinical practice which takes into account patient variations in [low density cholesterol] response, and no guidelines for predictive screening before commencement of statin therapy", they highlight.

Overall, people who hit the 40 percent mark had a 14 percent lower risk of cardiovascular disease.

They were on average 62 years old when they began treatment.

Professor Helen Stokes-Lampard, chairwoman of the Royal College of Global Positioning System, said: "When we prescribe medication, we have to rely on patients to make sure that they take it, both at the recommended dose and for the duration of time that we think will benefit them most".

The researchers reviewed data collected between 1990 and 2016 for more than 165,000 patients who weren't treated for heart disease or a stroke.

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Any reduction in cholesterol below 40 per cent after two years of statin treatment was deemed to be a "suboptimal" response.

After taking into account differences in age and underlying medical conditions, the researchers found that people who did not lower their LDL cholesterol enough were 22% more likely to develop cardiovascular disease than those who did lower it.

Weng and team say the findings provide "real world evidence" about statins and contribute to the debate on the effectiveness of statin therapy.

Indeed, the researchers did also find that a higher proportion of patients who had a "sub-optimal" response had been given lower-potency doses, compared with those who had an "optimal" response. The exact dosage of statins prescribed and patients' compliance to the prescriptions were not within the scope of the research.

Avkiran says that people who have been given statins, should continue to take them regularly, as prescribed, and should discuss any concerns about their medication with their GP.

Statins work by inhibiting CoA reductase, the enzyme responsible for the synthesis of cholesterol in the liver. Those who achieved their cholesterol goals were more likely to be prescribed more potent statins, probably because the group also started with higher levels of cholesterol, he said.

Some patients choose to come off statins, due to their side effects.

Improving your diet - in addition to weight loss, lowering the amount of sodium (salt) containing foods and drinking less alcohol has been shown to reduce cholesterol levels.

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