Prescription drugs like Lipitor, Crestor, and Zocor have become very familiar names in American homes. Statins are among the most commonly prescribed medications for lowering cholesterol, especially in the US. It is estimated that they are responsible for saving thousands of people each year, affected by heart disease. These drugs work by blocking a substance your liver needs to make cholesterol, the waxy substance that’s found in fat in your blood. This causes your liver to remove cholesterol from your blood.
While your body needs cholesterol to build healthy cells, having high cholesterol can increase your risk of heart disease – which is why statins are so often prescribed. High cholesterol, puts you at risk of developing deposits of fat in your blood vessels which can eventually impede blood flow through your arteries. If your heart does not get enough of the oxygen-rich blood it needs, your risk of heart attack increases. Similarly, decreased blood flow to your brain, due to clogged arteries, can cause a stroke. Because of these serious health risks, statins have been widely used to avoid atherosclerosis, coronary artery disease, heart attack and stroke.
About a year ago, however, new guidelines for the use of cholesterol-lowering statins were issued by the American heart Association. These new guidelines focused on risk assessment and determining who would benefit from taking the drugs. In effect, the new recommendations actually expanded the number of people eligible to take statins. They take into account age, gender, weight, blood pressure, and smoking status – rather than just LDL bad cholesterol values. Anyone who falls under moderate risk (or above) for heart attack or stroke should be prescribed statins according to the new guidelines.
But is putting more people on statins the answer? According to two new studies, yes. An estimated 41,000 to 63,000 cardiovascular events would be prevented over 10 years if the new guidelines are followed. Both new studies claim that the new guidelines are both efficient and cost-effective. The new research was published in JAMA and examined the new recommendations that those aged 40-75, with a calculated percent risk of 7.5 of having a heart attack or stroke over the next 10 years receive statin drugs.
This was an important analysis to make since the new guidelines would mean about 12.8 million more Americans being treated with statins. Researchers evaluated around 10 years of data and 2,500 people not on statins. They found that 39% of these people would be eligible for statin therapy under the new guidelines, compared to 14 percent under the old guidelines. Research also found that those who underwent cardiac events during the course of the study were more often those who had been advised to take statins under new guidelines recommendations.
More specifically, the results showed that the rate of heart attacks and strokes was 6.3% in the statin candidate group, compared to 1% among patients who wouldn’t be statin candidates under the new guidelines. More research is needed as the new results are based on a predominately white population, but on a positive note the risk calculator used for the new guideline considers race and ethnicity.
In the second JAMA study, researchers from the Harvard School of Public Health analyzed the cost effectiveness of the new guidelines. Seeing as how policymakers consider interventions costing less than $50,000 per QALY (quality-adjusted-life-year) cost effective, using statins more widely would put them in the green. They found that the cost of these new recommendations would be about $37,000 per QALY gained, the standard measure of how much a treatment costs to earn one year of healthy life.