More than two million heart patients face higher doses of statins or extra drugs to reduce cholesterol

More than two million heart patients could be given higher doses of statins or extra drugs to reduce cholesterol levels.

The National Institute for Health and Care Excellence (Nice) has set new targets for up to 2.1 million people with cardiovascular disease who have suffered a heart attack or stroke.

It estimates that up to 145,000 heart attacks, strokes and premature deaths could be prevented over the next decade if people’s cholesterol levels were lowered.

The guidance recommends that statins continue to be used, with patients given the highest level they can tolerate.

But if statins alone are not doing enough to cut cholesterol, then doctors should consider offering drugs known as PCSK9 inhibitors.

For the first time, the guidance sets a target of keeping a person’s low-density lipoprotein (LDL) cholesterol – often known as bad cholesterol – levels at 2.0 mmol per litre or less, or non-HDL cholesterol levels of 2.6 mmol per litre or less. This is where the HDL – good – cholesterol number is subtracted from the total cholesterol number.

Professor Jonathan Benger, Nice chief medical officer, said: ‘Improving the control of cholesterol in a larger number of people will further reduce deaths from heart attacks and strokes.’

The British Heart Foundation welcomed the proposals, urging them to be implemented as soon as possible.

Dr Shahed Ahmad, NHS national clinical director for cardiovascular disease prevention said: ‘The introduction of target cholesterol levels… will provide welcome clarity for both NHS clinical teams and their patients.’