An apple has the equivalent risk reduction for a heart attack as a statin drug, says Dr Aseem Malhotra, a cardiologist at the Frimley Park Hospital in Surrey. In fact, a range of lifestyle changes – such as more exercise and a healthier diet – is usually enough to dramatically reduce the risk of heart disease.
“More than 80 per cent of cardiovascular disease is attributable to environmental factors, notably unhealthy diet and also smoking, alcohol and physical inactivity,” says Dr Malhotra in a debate about lowering cholesterol levels.
But instead, doctors too readily prescribe a statin drug, the most frequently prescribed drug family, costing the UK’s National Health Service alone £450m a year.
Although studies have concluded that the drug is effective and well tolerated, most have been funded by the manufacturer and don’t reflect what is happening, where half give up taking the drug in the first year because of debilitating side effects such as muscle weakness and fatigue, says Dr Malhotra. Other side effects have included suicide and cancer, and there have been concerns the drugs are ineffective for women and the elderly.
Under current guidelines in the UK, men over the age of 60 and women older than 65 are routinely offered a statin as a just-in-case measure to prevent heart disease, even if they have only a one-in-10 chance of developing the condition. As a result, the UK prescribes more statins than any other European country and second only to the US in the world.
(Source: BMC Medicine, 2016; 14:4)
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