DRUGS to lower cholesterol should be prescribed far more widely because they significantly cut the rate of heart attacks and strokes even in low-risk patients, researchers say.
In an analysis of 27 studies, University of Sydney researchers found the risk of cardiovascular deaths was reduced by 15 per cent in low-risk patients who took the drugs, called statins, compared with those who did not.
The patients were considered to have a less than a 10 per cent risk of having a heart attack or stroke within five years, and are not recommended for statin treatment under current guidelines. But the researchers, from the National Health and Medical Research Council clinical trials centre, said the reduction in cardiovascular deaths achieved in the low-risk group was similar to that for high-risk patients.
The findings prompted them to call for a review of clinical guidelines so that low-risk patients were prescribed statins where lifestyle modifications such as diet and exercise failed to lower their cholesterol.
Study co-author Professor Anthony Keech said statins could benefit about a third of men aged over 50 and women over 60 who were at low risk of cardiovascular disease.
Current guidelines recommend diet and exercise changes for patients in this group. They state that statins should be considered in patients with a 10 to 15 per cent risk of a heart attack or stroke, in cases where lifestyle change has been unsuccessful and there are persistent risk factors such as hypertension or a family history.
Writing in The Medical Journal of Australia, the researchers said there was now ''considerable evidence that statin therapy reduces cardiovascular events'' in low-risk patients.
''While there is no substitute for lifestyle modification, the capacity for statin pharmacotherapy to assist in the treatment of individuals at lower risk has now been shown,'' they said.
''This new evidence must be urgently considered, with appropriate economic analyses, for incorporation into clinical and PBS [Pharmaceutical Benefits Scheme] guidelines.''
Their analysis found that for every 1000 low-risk patients who took statins, about 11 avoided major vascular events such as heart attacks or strokes.
Statins are the most commonly prescribed drugs in Australia with about 2 million people taking them to reduce heart attack risk. They comprised two of the top three most dispensed medications under the government's list of subsidised medicines in 2010-11, at a cost of more than $1 billion.
An expert advisory committee for the PBS is currently reviewing the cost of statins after one of the major brands lost its patent protection, opening the door to low-cost generics.
The director of the Baker IDI Heart and Diabetes Institute, Garry Jennings, said The University of Sydney study suggested the benefits of taking statins could outweigh the costs for a larger number of Australians.
''Statins have now been around for several decades so we know they're really safe, and now some of them are coming off patent they are going to be considerably cheaper than they have been in the past,'' he said. ''Those things have influenced the cutoff in the past, and they could be reconsidered.''
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