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Older men with heart disease are missing out on drugs that would reduce their risk of having another heart attack, research suggests. A study indicates that the over-60s are not being prescribed statins - cholesterol-lowering drugs which have been shown to reduce the chance of a second heart attack in some heart patients.
Guidelines recommend that all patients with a history of heart attack or angina be prescribed them. But family doctors are not doing so, according to the authors of a study published in the medical journal Heart.
A team at St George's Hospital in London looked at the records of over 3,000 men aged between 60 and 75 from family doctor lists in 24 British towns.
The men are part of the British Regional Heart Study, and have been monitored for more than 20 years.
Only just over a third of the men who had had a heart attack and a fifth of men with angina, were taking cholesterol-lowering drugs.
Among those actually taking the drugs, only a third were taking adequate doses.
High risk
The researchers say statins tend not to be given to older patients with long-standing heart disease, but they do not know why.
"These drugs provide the greatest benefit in patients with the greatest risk," Professor Peter Whincup, of the department of public health sciences at St George's, told BBC News Online.
"There isn't clinical justification for not treating older people."
He said it was possible that older people with heart disease were being discriminated against.
Other factors could be to blame, however. One possibility is that older heart patients are more likely to have other illnesses, which might prevent statins being taken.
Belinda Linden, Head of Medical Information at the British Heart Foundation (BHF), said the study was very worrying, as statins had been found conclusively to reduce mortality and morbidity.
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"There isn't clinical justification for not treating older patients" |
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Prof Peter Whincup |
"Despite clear recommendations set out by the National Service Framework in 2000, many health professionals remain uncertain about the ideal time that people should be receiving statin therapy," she told BBC News Online.
The BHF would soon be producing a patient's guide which would allow patients and health professionals to have a better understanding of when statins should be taken, she added.
Early benefits
A second study of statins, revealed in the Journal of the American Medical Association, suggests that starting the drugs within days of a heart attack may be of benefit to patients with very high cholesterol levels.
Cardiologists at the Duke University Medical Center found that giving statins to heart patients before they left hospital rather than after discharge improved compliance.
Dr Kristin Newby said: "While we were unable to prove that early use of statins had any effect on mortality, one encouraging result was that 91% of the patients started on statins were still taking them 90 days later."
She added that compliance was the key for success in using statins because it can take a while for the benefits to be seen.
Statins work by slowing down the rate at which the liver makes its own cholesterol.
This helps reduce levels of cholesterol in the blood, making it less likely to clog the arteries.
[BBC News Online]
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Last Revised at December 10, 2007 by Lusine Kazoyan, M.D.
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