Health Watch

Why over- 40s should take cholesterol busting statins

Everyone over the age of 40 should take cholesterol-busting statins, an eminent heart surgeon says.

Professor Sir Magdi Yacoub, who has carried out more heart transplants than anyone else, said the benefits of taking the controversial drugs ‘massively’ outweigh the risks and to not make them more widely available is ‘lunacy’. Sir Magdi, professor of cardiothoracic surgery at Imperial College London, also believes statins should be available without a prescription.

Statins are the most-widely prescribed drugs in Britain and are credited with saving thousands of lives a year by preventing heart attacks and strokes.

But a row is raging about their side-effects.

A report published in the British Medical Journal said the cholesterol-lowering drugs, taken by eight million Britons, cause side-effects such as liver and kidney disease and diabetes in one in five patients.

Parts of the article were withdrawn last week, following repeated criticism from an Oxford University academic that the risks had been exaggerated up to 20-fold.

Sir Rory Collins said the figure is one in 100 and described the published claims as a ‘huge error’ that will ’cause unnecessary deaths’ by discouraging patients from taking the medicine.

Now, Sir Magdi has said that stopping taking the drugs would be disastrous.

He told BBC Radio 4’s Today programme on Saturday that he found the row very upsetting, adding: ‘It is almost certainly going to result in people not taking statins and that is a major worry to many of us because the evidence is overwhelming, the lower the cholesterol, the healthier you are and the longer you will live.

He then called for the drugs to be easier to access – and for more people to take them.

Sir Magdi said he believed statins should be available from chemists without prescription and that everyone over 40 should take them.

He said that side-effects pale into insignificance when compared with the benefits and ‘not to make use of what we have is lunacy’. Sir Magdi said: ‘The drug has been around for 25 years or so and we do know the long-term results and exactly what it does biochemically.

‘We know exactly how to monitor any complications which are very minor compared to the benefits so I don’t see the problem.’

Currently, the prescription of statins is based on health, rather than age, with anyone judged to have a 20 per cent risk of a heart attack in the next decade offered them.

But millions more could soon take the pills, as the cut-off is expected to be lowered to 10 per cent.

Some doctors have questioned the mass-medication of essentially healthy people and say there are better ways of spending NHS money.

Dr Mike Knapton, a GP and associate medical director at the British Heart Foundation, said: ‘I am not sure we are yet in a position where everybody over a certain age should be prescribed a statin.

‘Even if in theory it would have public health benefits it could turn life into a disease.’



Killer pimple: Doctors warn of aggressive form skin cancer


Dermatologists have raised the alarm on an aggressive form of melanoma that looks like a harmless pimple but kills hundreds of Australians a year.

Diagnosis delays mean people with the cancer are six times more likely to die than from other melanomas.

Nodular melanomas usually appear on the skin as a red nodule rather than an ugly dark mole, leading doctors to mistake them for relatively harmless forms of skin cancer or even pimples.

But the key difference is that these melanomas are firm to touch, and will not feel soft like a pimple or a mole.

Nodular melanomas are particularly aggressive and should be diagnosed within two months, says Associate Professor John Kelly, a speaker at the annual scientific meeting of the Australasian College of Dermatologists in Melbourne.

They are responsible for just 15 per cent of melanoma cases but cause 43 per cent of melanoma deaths.

In Australia, that’s around 550 deaths a year. But health professionals in general are not aware of what to look for, says Prof Kelly.

‘The patient is often told there is nothing to worry about,’ he said.

Prof Kelly has called on doctors to familiarise themselves with the often harmless-looking but deadly nodular melanomas so that more lives can be saved.

Currently, only about 41 per cent of nodular melanomas are accurately suspected to be melanoma at the time of removal.

Nodular melanomas are also more deadly because they grow rapidly in depth – normally at four times the rate of other melanomas.

Warning signs to look out on lumps are that they are new, firm, red, dome-shaped and have been growing progressively bigger for more than a month.

Prof Kelly said nodular melanomas are more common in older men but stressed that anyone can get them.

‘This kind of melanoma we see more often in older men and on the head and neck rather than trunk and limbs,’ he said.

‘But that’s just a slight preference it’s not that they all occur in older men.’

Prof Kelly wants doctors and patients to take urgent action if there’s a ball on the skin that becomes bigger over a couple of months. Some of it is under the skin and some is above.

‘If it has has been present for more than a month and grows bigger and bigger, it needs urgent removal.

‘But we don’t want to cause hysteria about every red nodule that people get.

‘Something that has been stable for more than a year is not going to be a worry. And something that has been present of only days or weeks is probably also not a worry.’


* Melanoma is the fourth most common cancer diagnosed in Australia

* They are more commonly diagnosed in men than women

* Melanoma risk increases with exposure to UV radiation, particularly with episodes of sunburn

* Five year survival for people diagnosed with melanoma is 91%, rising to 99% if the melanoma is detected before it has spread

* Nodular melanomas are responsible for just 15 per cent of melanoma cases but cause 43 per cent of melanoma deaths.


Urine not sterile: Study debunks myth


It has long been thought that human urine is sterile, but new research suggests this is not the case.

Scientists found bacteria live in the bladders of healthy women, meaning their urine is not sterile after all.

However, the researchers also found that the bacteria in the urine of healthy women are different to those found in the bladders of women with overactive bladders.

This finding could pave the way for new treatments for women with the condition which means they suffer sudden urges to urinate.

‘Doctors have been trained to believe that urine is germ-free,’ said Dr Linda Brubaker, from Loyola University Chicago Stritch School of Medicine.

‘These findings challenge this notion, so this research opens the door to exciting new possibilities for patient treatment.’

Evann Hilt, lead investigator and second year master’s student at the university added: ‘The presence of certain bacteria in women with overactive bladder may contribute to [their] symptoms.

‘Further research is needed to determine if these bacterial differences are clinically relevant for the millions of women with [overactive bladder] and the doctors who treat them.’

Approximately 15 per cent of women suffer from overactive bladder and yet an estimated 40 to 50 per cent do not respond to conventional treatments.

‘If we can determine that certain bacteria cause [overactive bladder] symptoms, we may be able to better identify those at risk for this condition and more effectively treat them,’ said Dr Alan Wolfe, co-investigator and professor of Microbiology and Immunology.

Researchers evaluated urine samples from 90 women with and without overactive bladder.

They used a new technique which enabled them to detect bacteria that would not previously have been identified.

The researchers now plan to determine which bacteria in the bladder are helpful and which are harmful.

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