Doctor is ‘unsung hero’ for prescribing drugs

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Statins are already the most commonly-prescribed medicines in the UK – but according to new recommendations which lowered the bar for prescriptions, they should be handed out to four-and-a-half million more people to reduce cholesterol levels in their bodies.

The guidance means four in 10 adults in England, Wales and Northern Ireland are now eligible for the drugs, even though many are at low risk of a heart attack or stroke.

The decision by the National Institute of Health and Care Excellence has been met with anger by some medics, who say the medicines have unpleasant side-effects such as diabetes and muscular pain.

Opponents also claim the evidence used to draw up the guidelines is based on trials sponsored by pharmaceutical companies.

But for retired Sheffield GP Dr John Revill, the recommendations justify a campaign which marked the last 25 years of his career with controversy.

Dr Revill ‘aggressively’ used statins to ward off heart disease, strokes and heart attacks, before most doctors had even heard of the drugs.

He claims the policy, which he launched in 1988, saved more than 100 lives and reduced the death rate to almost zero in Greenhill, where he practised.

Dr Revill was hailed as an ‘unsung hero’ of the NHS when NICE issued the new guidelines, which it is promised will save more lives.

Cardiovascular disease is the UK’s biggest killer, claiming 180,000 lives a year, and is behind one in three deaths.

Statins reduce the build-up of fatty plaques that lead to blockages in blood vessels.

Crucially, say NICE experts, the crusading Dr Revill left a little-studied legacy of 30 years’ worth of ‘meticulously-collected’ health and mortality data.

An article published in the British Journal of Cardiology last month said the doctor almost banished death from heart disease among people under 70 from his patient list.

Deaths from cardiovascular causes in the under-70s ‘dropped by nearly 90 per cent’ in Greenhill between 1981 and 2012, while deaths from heart disease plummeted by ‘more than 50 per cent’ in the same period.

“We knew mortality from ischaemic heart disease was directly related to the levels of cholesterol, and that by offering healthy lifestyle advice and prescribing statins to at-risk patients, we could eliminate mortality from these diseases,” said Dr Revill.

Years ahead of official advice, he prescribed statins to patients at 15 per cent risk of heart attacks, when the national guidance then suggested only prescribing to those at 30 per cent risk.

But his behaviour came at a cost. Dr Revill now admits that he was ‘effectively forced out’ by the local health authority over his policy - but added that he ‘doesn’t condemn’ his bosses.

“That was just the way it was then, and for my part I couldn’t turn around and tell patients that I wouldn’t prescribe a treatment that I knew to work,” he said.

The British Medical Association’s General Practitioner’s committee are among the critics opposed to handing out more prescriptions for statins. “There is insufficient evidence of significant overall benefit to low-risk individuals to allow GPs to have confidence in the recommendation,” said the committee.

It said the measure would ‘distort health spending priorities and disadvantage other patients’.

However, Maureen Talbot, senior cardiac nurse at the British Heart Foundation, said: “The prescription of cholesterol-lowering medications has been increasing steadily for many years.

“This reflects the efforts that have been made to better identify people at high risk of developing cardiovascular disease.

“Statins have been proven to be safe and effective and are vital in helping reduce people’s risk of heart attack and stroke.”