A New Plan to Restrict Cardiovascular Diseases in Scotland

Scottish Intercollegiate Guidelines Network (SIGN) has published a set of guidelines that are aimed at averting 7,200 deaths and 27,000 cardiovascular complaints like heart attacks and strokes in the next five years.

The plan aims to provide preventive treatment to about 500,000 people considered to be at risk. It recommends periodical risk assessments for all over-40s especially those most at risk and also aims to provide lifestyle advice.

As per the guidelines, it is expected that 50% of men in Scotland and 20% of women over the age of 40 could be prescribed statins. Statins are medicines used to lower cholesterol levels and are often prescribed to people deemed to be at risk of cardiovascular disease (CVD). The guidelines are expected to cost NHS £78 million a year as they also include treatment of people already affected by CVD.

Doctors and charities welcomed the guidelines except a few who are against usage of statins for prevention. The latter have expressed anxiety about such 'mass medication', more so because statins cause side effects like headaches, abdominal pain and, very rarely, severe muscle inflammation.

Dr Mike Knapton, from the British Heart Foundation said, 'I, like a lot of others, am concerned about medicating huge numbers of people.'

'While I am convinced that the evidence is there that statins work and are safe, I am also convinced that prevention is better than anything else. That means making sure people eat healthily, stop smoking, lose weight and reduce their risk of heart disease in those ways.' Professor Tom Sanders, nutrition director for charity Heart UK, said,' Statins are not a substitute for a healthy lifestyle. They are useful in people at high risk, but as a population you could reduce the risk by up to 80 per cent with a life-long better diet, more exercise and stopping smoking. Statins should really be a last resort.'

Dr David Haslam, from the National Obesity Forum, welcomed the idea but said, 'There is always the danger that people will think it is either one thing or the other and believe that once you are on pills you can do what you like.'

Previous studies show statins are several times safer than aspirin. 'It is very difficult to reduce cholesterol by even 10 per cent with changes to your diet alone. But with statins it can fall by 30, 40 or 50 per cent.'

As per the new guidelines anyone with a 20 per cent risk of getting coronary heart disease (CHD) or a stroke within ten years will be advised to take statins. Older people, smokers and the overweight are considered more at risk.

GPs will use an assessment tool called ASSIGN to measure risks, which include a previous heart attack, stroke, angina or heart failure or diabetes or family history of high cholesterol. This assessment will also look into the place where you live as evidence shows deprivation and stress also add to heart problems.

Source-Medindia
PRI/M