10:00PM GMT 25 Dec 2013
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Britain has become the “statins capital” of Europe - and has the second highest prescribing levels in the Western world for the drugs to protect against strokes and heart attacks, an international study has found.
Last night, the former heart tsar said doctors in this country were handing out too many pills to the “worried well” and those living “indolent” lifestyles who were not prepared to take steps to improve their own health.
Increasing numbers of patients in this country have been put on statins in the last decade, amid spiralling obesity and more aggressive prescribing of the medications by family doctors, whose pay is linked to take-up of the pills among their patients.
The study by the Organisation for Economic Co-operation and Development (OECD), which examined 23 industrialised nations, found that this country has the highest levels of statins prescribing in Europe.
The pills, which cost the NHS less than 10p per patient per day, are now the most commonly prescribed medication in Britain, with eight million people on some type of anti-cholestoral drug.
Medical regulators are currently considering whether to go further and follow American guidance - which could mean a doubling in the numbers on the drugs.
Some cardiologists have suggested they should be automatically prescribed to all patients from the age of 50.
But others have said they are “disturbed” by the trend to dispense the pills ever more widely, exposing millions to potential side-effects.
Research has suggested up to one in five patients taking the drugs suffers some kind of ill-effect, including muscle aches, memory disturbance, cataracts and diabetes.
The new study says that while use of the cholesterol-lowering drugs has more than tripled across OECD countries between 2000 and 2011, levels in the UK are 40 per cent higher than average.
Britain had the highest prescribing levels of all European countries examined, with 13 per cent of the population on the drugs, in a shared position with the Slovak republic. Across all 23 OECD countries examined, only Australia had higher levels of prescribing, with 13.7 per cent of the population on statins.
Valerie Paris, an economist from the OECD’s health division, said Britain’s high place in the tables could be because GPs are given financial incentives to identify and treat heart disease as part of pay contracts which reward doctors for identifying and treating a long list so of diseases.
She said: “The question is whether these people are given advice about improving the lifestyle, or are they put quickly on to statins?”
Prof Sir Roger Boyle, Government heart tsar from 2000 to 2011, said he was concerned that too many doctors were adopting a blanket approach to the drugs, instead of targeting them closely, and offering more patients lifestyle advice.
He said: “The question is whether we are effectively targeting the statins accurately. I would like to see a rather more rigorous approach - rather than them being offered to the ‘worried well’ and giving them to people because they are 50, or 55, without a proper risk assessment.”
Prof Boyle said statins had played an important part in Britain’s battle with heart disease - with a 55 per cent reduction in deaths from heart attacks and strokes in the past eight years - but said doctors needed to do far more to convince the public to tackle unhealthy habits.
The cardiologist said: “I think we have a lot further to go in helping people make the choices to help their lifestyles - smoking, exercise and diet - the things that are actually far more difficult. We are the fattest in Europe; we have got a whole lot more to do to tackle the indolence and girth of the population.”
The former national director for heart disease said: “Statins are a very cheap and cost effective way of improving the health of the nation .. but if we were starting afresh we might not put so much emphasis on them.”
In October, an analysis published in the British Medical Journal cautioned against any expansion in prescribing.
One of its authors, Dr John D Abramson, clinical instructor of primary care, from Harvard Medical School, said wider use of statins “will benefit the pharmaceutical industry more than anyone else”.
“Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking,” he said.
The OECD report, Health at a Glance, says that in Germany, just seven per per cent of the population is on anti-cholesterol drugs and in France nine per cent, the study found.
The United States - where around 15 per cent of adults are currently estimated to be on statins - was not included in the research.
Maureen Talbot, Senior Cardiac Nurse at the British Heart Foundation, said: “We know that two thirds of the adult population in the UK have elevated cholesterol. Statins have been a great tool for doctors to help people who can’t lower their cholesterol level and therefore their risk of a heart attack or stroke, with positive lifestyle changes.”
Tam Fry, from the National Obesity Forum, said he feared GPs were prescribing statins too readily because it was “simpler to reach for the pad and write out a prescription” than to dole out lifestyle advice.
He said the festive season was a good time for people to take stock of their habits.
“A lot of people will have taken on twice the number of calories that they need over Christmas Day, and unless they spend an hour or two walking it off on Boxing Day it will hang around them - and that’s no good,” he said.
“The priority on Boxing Day is a to go on a walk - as brisk as you can, for as long as you can,” he added.
OBESITY
The OECD study confirms that Britain is the fattest nation in Europe – with 24.8 per cent of adults classed as obese - a body mass index of 30 or more - compared to just 12.9 per cent in France.
In the international league table, average obesity levels are 17 per cent, with the UK only exceeded by Chile, Canada, Australia, New Zealand, Mexico and the US, where 36.5 per cent of adults are obese.
DIABETES
The OECD study also shows that the UK is in the top three countries for prescribing drugs for diabetes - a disease which is often linked to high level of obesity.
Almost 8 per cent of people in the UK – around 4.5million – are on such medication, ranking just behind Finland and Germany.
The report says: “This growth can be explained by a rising prevalence of diabetes, largely liked to increases in the prevalence of obesity – a major risk factor for the development of Type-2 diabetes.”
ANTI-CHOLESTEROL DRUGS
Prescription of statins or statin-like medication, 2011
Daily doses per 1,000 people per day
1. Australia 137
2= UNITED KINGDOM 130
2= Slovakia 130
4. Belgium 122
5. Norway 116
6. Denmark 115
7. Luxembourg 112
8. Canada 109
9. Netherlands 101
10. Hungary 98
11. Finland 95
12. Slovenia 93
13= Czech Republic 92
13= France 92
15. Spain 90
16. Portugal 88
17. Iceland 80
18. Sweden 77
19. Italy 72
20. Germany 68
21. South Korea 34
22. Estonia 32
23. Chile 10
OECD AVERAGE 91
