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Older men with coronary heart disease missing out on statins
June 17, 2002Older men with diagnosed coronary heart disease are missing out on statins, shows research in Heart. And inadequate doses are often being given to those who are prescribed the drugs.
The researchers analysed the records of over 3000 men aged between 60 and 75 from family doctor lists in 24 British towns. All the men are part of the British Regional Heart Study, and have been monitored for over 20 years.
Of the 286 men who had had a heart attack, only just over a third were taking drugs to lower cholesterol, of which statins comprised the majority. Among the 360 men with angina indicative of narrowed and hardened arteries, only a fifth (23%) were taking cholesterol lowering drugs. The overall prevalence of statin use among men with confirmed heart disease reached only 29 per cent.
Among the men taking cholesterol lowering drugs, only a third were taking doses based on trial evidence. Statins tended to be given to those who had undergone bypass surgery, been recently diagnosed, and who were at the younger end of the age range, and not to older patients with longstanding disease.
The National Service Framework for Coronary Heart Disease recommends that all patients with a history of heart attack or angina should be prescribed statins to reduce total cholesterol to below 5.0 mmol/litre, or by 30 per cent, whichever is the greater, to prevent deterioration or recurrence of their disease.
But the authors conclude that family doctors are underprescribing statins, despite the fact that the drugs have been shown to be cost effective in the secondary prevention of coronary heart disease.
British Medical Journal (BMJ)
Among the men taking cholesterol lowering drugs, only a third were taking doses based on trial evidence. Statins tended to be given to those who had undergone bypass surgery, been recently diagnosed, and who were at the younger end of the age range, and not to older patients with longstanding disease.
The National Service Framework for Coronary Heart Disease recommends that all patients with a history of heart attack or angina should be prescribed statins to reduce total cholesterol to below 5.0 mmol/litre, or by 30 per cent, whichever is the greater, to prevent deterioration or recurrence of their disease.
But the authors conclude that family doctors are underprescribing statins, despite the fact that the drugs have been shown to be cost effective in the secondary prevention of coronary heart disease.
British Medical Journal (BMJ)
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