N.H.S Changes Advice on Asprin

Here we go again. This morning's BBC Breakfast reported that the  N.H.S. has changed it's advice on the use of aspirin for those with a risk of having a heart attack. I have been taking soluble aspirin as part of my medication routine since I had my heart attack in May 2006 so the news was of great interest to me. The Daily Telegraph reported it as follows:

'More than a million people with a common heart condition have been told not to take aspirin to guard against stroke, in a reversal of previous N.H.S. advice.'

'New medical recommendations warn that the pills are ineffective in reducing the danger for those suffering heart rhythm disorders and that the risk of side-effects outweigh the benefits.'

'Up to 7, 000 strokes and 2,000 premature deaths a year could be prevented if patients were put on new drugs instead, experts said.'

'Until now, adults suffering from arterial fibrillation have been advised to take a daily dose of aspirin- a blood-thinning drug- as the heart condition often causes clots, leading to a risk of stroke that is five times higher in other people.'

But revised guidance from the National Institute of Health and Care  Excellence (NICE) says a new generation of drugs is far better than aspirin at reducing the danger for such patients and is less likely to cause side-effects including internal bleeding.'

'Patients are advised to seek medical advice from their GP before stopping their current medication, but the guidance recommends that anticoagulant drugs which prevent clots should be prescribed instead.'

I will not be stopping my use of aspirin until I've spoken to my doctor as I don't obviously want to risk having a blood clot again which could cause another heart attack. All this chopping and changing over the use of various medications such as aspirin and statins which I take to prevent another heart attack is just a little bit confusing and annoying, to say the least.

'Thousands More to be prescribed statins in new NICE guidelines'

BBC Breakfast television news this morning had an item about NICE's  (National Institute for Health and Care Excellence) recommendations that more people should be prescribed statins to reduce cholesterol levels in their blood.

The following is a quote as it appears on the NICE website:

'Thousands more people could be prescribed statins to help lower cholesterol levels and reduce the risk of heart attacks and strokes, under draft guidance.'

'In an update to the existing guideline on lipid modification, NICE is proposing that the threshold be halved for offering statins to people to prevent cardiovascular disease (CVD), the cause of 1 in 3 of all deaths in the UK.'

'Currently, only people with a 20 per cent or greater 10-year risk of developing CVD are offered statins. Draft guidance now recommends offering statins to people who have a 10 per cent or greater 10-year risk of developing CVD.'

'As many as 7 million people in the UK are currently believed to take statins, at an estimated annual cost of £450 million.'

'GPs should estimate the level of risk among their patients using the QRISK2 assessment tool and measurements including whether or not they smoke, their cholesterol levels, blood pressure, and body mass index. The calculator then provides a percentage risk of developing CVD in the next 10 years.'

'NICE had previously recommended the US Framingham risk tool before withdrawing advice about which risk assessment tool to use in February 2010. New evidence has suggested that QRISK2 is a more accurate CVD risk tool particularly among ethnic populations.'

'Patients with type 2 diabetes should, however, have their risk assessed using the UKPDS risk tool.'

'NICE recommends that GPs start statin treatment for the primary prevention of CVD with atorvastatin 20 mg. Patients with established CVD, type 1 diabetes or type 2 diabetes should be offered a higher strength 80mg dose of atorvastatin.'

I have been on statins since I had my heart attack in 2006. As I have mentioned in earlier posts on this blog, I had tried various forms of statins, Simvastatin for example, some of which had quite extreme side-effects, one being, when I was in hospital, being like having flu, muscle cramps,etc etc until I eventually settled on Pravastatin, which is what seems to have the least of the side effects. Reading the leaflet which is enclosed with the tablets you can see what these might be. They are, to mention only a few:

insomnia, dizziness, tiredness, headaches, sleep disturbances (surely insomnia would cover that?), muscle and joint pain, nausea, diarrhoea, wind, (I'm sure I suffer from most of these, unfortunately. I'm not so sure whether it's because of the statins though.) 

I think personally it's best to have a decent diet, low or fat-free food, for example I have always had semi-skimmed milk and use low-fat spreads instead of butter, eat plenty of fresh fruit and vegetable, give up smoking (I have never smoked so that doesn't matter to me, and cut down on alcohol intake (I drink very little so that doesn't effect me. I'd personally rather spend the money on a good book than alcohol, so I don't find that a hardship to give up.) Also, take plenty of exercise (we recently joined a gym and go swimming twice a week, and walk regularly. Not perhaps at the moment, but that's down to the poor weather, unfortunately. 

I don't personally think just putting healthy people on statins is such a good idea. If they have a risk of stroke or heart attack, maybe it's a good idea. As there was a family history of heart problems in my family then it would have been a good idea to be prescribed statins (as it happened I wasn't. Would it have prevented me having a heart attack? That, of course, is open to doubt. I was told by my doctor years ago to go on a low-fat diet, which is one reason why I went over to using semi-skimmed milk. It took some getting used to after having full-fat milk, but now I actually prefer it. Some low fat products are frankly awful, thin, tateless and now particularly nice, but there are quite  few quite nice alternatives, such as spreads, yoghurts etc etc.)