Proper drug-taking would greatly cut heart risks

LONDON (Reuters) - Encouraging more patients to continue taking their prescribed cholesterol drugs would stave off twice as many stroke and heart attack deaths as giving the drugs to a wider range of people, scientists said on Tuesday.

A study by British researchers suggested that rather than widening the pool of patients, as recommended by U.S. government health advisers for some cholesterol-lowering statin drugs, more effort should made to encourage those in high risk groups to take the statins they are prescribed.

Heart disease is the biggest killer of men and women in Britain, the United States and other industrialized countries. The World Health Organization says heart diseases and diabetes accounted for 32 percent of all deaths globally in 2005.

Statins like AstraZeneca's Crestor or Pfizer's Lipitor can lower so-called "bad" or low-density lipoprotein (LDL) cholesterol and reduce the risk of heart attacks or stroke, but experts say only around half of people prescribed such drugs continue taking them in the long term.

The U.S. Food and Drug Administration said last month that Crestor could be promoted in a large new market of people with normal cholesterol levels but other heart disease risk factors.

But the British study found that improving the compliance rate by 50 percent in those already prescribed statins would prevent far more heart attacks and strokes than prescribing them for a larger group of patients.

"Generally people need to be taking these statins for the long term -- often for the rest of their lives," Amir Shroufi, who led the study, told Reuters. "You have to go on taking them for quite a while to really get the benefit."

Shroufi said it was not surprising that concentrating on enhancing treatment among high risk patients would yield greater benefits than widening the pool to include lower risk patients.

But the size of difference was notable, he said, and underlined the need to find more effective ways of getting people to stick to their medication.

Health authorities in Britain recommend that anyone with a 20 percent or greater chance of having a heart attack or stroke over the next 10 years should be prescribed a statin.

The study, published in the Journal of Epidemiology and Community Health, used data on blood pressure and total cholesterol for more than 38,000 patients in Australia to calculate the likelihood of developing cardiovascular disease and the relative advantages of different preventive strategies.

Using the 20 percent prescribing guidelines and with half of patients sticking to their statin medication, an estimated 174 heart disease cases and 70 deaths would be averted, they found.

And while widening the treatment criteria would prevent another 70 cases of heart disease and 18 deaths, improving long term compliance would prevent roughly twice as many -- an extra 91 cases of heart disease and 37 deaths.

Shroufi said one the best ways of boosting patients' adherence to statin medication was for doctors to give a clearer explanation of the long-term benefits of the drugs. Reminder techniques using everything from fridge magnets to text messages would also help, he said.

(Editing by David Cowell)