Number of strokes in UK predicted to rise by 44% in next 20 years

The number of strokes in the UK is expected to increase by almost half over the next 20 years owing to the ageing population, according to a study.

Over the same period, the number of stroke survivors is predicted to rise by a third, raising questions about how the already stretched NHS and social care services will cope.

King’s College London analysed data from 35 European countries, finding that the number of strokes across the continent is likely to rise by a third (34%) by 2035. But the increase in the UK is expected to be more pronounced at 44%, owing to the rate at which the country’s population is ageing relative to many other European countries.

By 2035 the number of UK stroke cases is expected to increase by 44% to about 62,000 a year

Alexis Wieroniey, deputy director of policy and influencing at the Stroke Association, said: “The predicted rise in the burden of stroke is largely due to our ageing population, as the risk of having a stroke increases as you get older. It is a worrying forecast, but it is not inevitable.

“Most strokes are preventable and everyone can take steps to lower their risk of stroke as they get older. Obesity can increase your risk of stroke by at least 64%. However, simple lifestyle changes like eating healthier meals, taking regular exercise and stopping smoking, along with checking your blood pressure regularly, can greatly reduce your risk.”

According to the Stroke Association, an estimated 1.2 million people are currently living with the effects of stroke. It says there are more than 100,000 strokes each year.

Spending on stroke patients

The King’s College London analysis is published on the same day as the British Medical Association warns that the UK is facing a health time bomb owing to a failure in addressing the burden placed on the NHS by obesity, smoking and alcohol consumption.

The BMA points to figures showing that nearly one in six adults still smoke, 7.8 million adults binge drink and obesity rates remain stubbornly high. It says there has been a failure to publish a new tobacco control plan and a lack of recognition of the need for a new alcohol strategy. It also describes the childhood obesity strategy as “watered-down”.

In its manifesto, A Vote for Health, the BMA says whichever party wins the general election should reverse the £400m of public health cuts taking place between 2015-16 and 2020-21.

Dr Mark Porter, chair of the BMA council, said: “In England, successive governments have failed to deliver a long-term plan to improve public health, and too often evidence-based public health measures have been kicked into the long grass. We need tighter regulation of the food and soft drinks industry, a minimum unit price on alcohol and support for people to quit smoking.”

The Stroke Association says a plan to tackle strokes is also essential given the projected rise in the number of cases. The current stroke strategy for England is scheduled to end this year, leaving it as the only UK nation without such a plan.

A Conservative party spokeswoman said: “We are committed to improving the health of the nation. Smoking rates are now the lowest in our history, with cancer survival the highest, and we’ve put in place a childhood obesity plan Public Health England calls the most ambitious in the world.

“But the truth is that this all depends on a strong economy – we spent £3.4bn on public health programmes last year – which Jeremy Corbyn would risk with his nonsensical economic ideas.”

Number of strokes in UK predicted to rise by 44% in next 20 years

Drug which cuts "bad" cholesterol can help prevent heart attacks and strokes

A new drug can prevent heart attacks and strokes by cutting bad cholesterol levels, scientists have found.

An international trial of 27,000 patients found that those who took the drug evolocumab saw their bad cholesterol levels fall by around 60% on average.

The patients in the trial were already taking statins, which are used to reduce low-density lipoprotein (LDL) cholesterol. Despite this, the patients who took evolocumab saw their bad cholesterol levels fall even further. They were also less likely to suffer from a heart attack or stroke than those who took the placebo.

The study found that for every 74 people who took the drug for two years, one heart attack or stroke would be prevented.

However, the findings, published in the New England Journal of Medicine, found that the drug had no impact on the rate of cardiovascular mortality.

Prof Peter Sever, from Imperial College London – which led the UK branch of the study, said: “This is one of the most important trials of cholesterol-lowering since the first statin trial, published 20 years ago. Our results suggest this new, extremely potent class of drug can cut cholesterol dramatically, which could provide great benefit for a lot of people at risk of heart disease and stroke.”

There are approximately 2.3 million people living with coronary heart disease in the UK, according to the NHS. It is responsible for more than 73,000 deaths a year in the UK, and occurs when fatty substances build up in the arteries, making it harder for blood to get to the heart.

Prof Sir Nilesh Samani, medical director at the British Heart Foundation, said: “Coronary heart disease is the single biggest killer in the UK and worldwide and ‘bad’ LDL-cholesterol is a major cause.

“While statins have had a significant impact in reducing the risk of heart disease for millions of people, they are not tolerated by everyone and only reduce cholesterol by a certain amount.

“A promising new approach is blocking the action of PCSK9, a molecule which reduces the breakdown of LDL-cholesterol in the liver. Creating new treatments which use this approach could prove life-saving for patients with high cholesterol and those who can’t tolerate statins.”

Drug which cuts "bad" cholesterol can help prevent heart attacks and strokes

Statins prevent 80,000 heart attacks and strokes a year in UK, study finds

Statins to lower cholesterol prevent 80,000 heart attacks and strokes every year in the UK, far outweighing the harm from rare side-effects, according to a review of the evidence which aims to put a heated controversy to rest and reassure the public that statins are safe.

The review is published by the Lancet medical journal, whose editor, Richard Horton, likened the harm done to public confidence by the critics of statins to that caused by the paper his journal published on the MMR (measles, mumps and rubella) vaccine in 1998.

“Controversy over the safety and efficacy of statins has harmed the health of potentially thousands of people in the UK,” he wrote in a comment published with the review. In six months after the publication of “disputed research and tendentious opinion” on the side-effects of statins in 2013, a study estimated that over 200,000 patients stopped taking a statin. It predicted there would be 2,000 extra heart attacks and strokes over the next decade as a result.

The Lancet was taking a stand, he said, “because of our experience of MMR. We saw in a very painful way the consequences of publishing a paper which had a huge impact on confidence in a safe and effective vaccine.

“We learned lessons from that episode and those lessons need to be widely promulgated. They are lessons for all journals and all scientists.”

The furore over statins broke out after Nice, the UK’s National Institute for Health and Clinical Excellence, advised doctors in 2013 to prescribe statins for patients with a low, 10% risk of heart disease in the next 10 years, which was half the previous level of a 20% risk. It made 4.5 million more people, who were fundamentally healthy, eligible for statins, which Nice said could prevent up to 28,000 heart attacks and 16,000 strokes each year.

The guidance, which was based on evidence from the group led by Prof Rory Collins at the clinical trials service unit at Oxford University, was questioned by the British Medical Journal, which is campaigning against the over-use of medicines and medical treatment. The BMJ ran two papers claiming statins did not reduce deaths and that the risk of side-effects outweighed the benefits.

Collins severely criticised the papers and the BMJ, arguing in the Guardian that they could harm more people than Wakefield did with his MMR paper. Wakefield suggested a link between the jab and autism, deterring some parents from having their children vaccinated.

In the light of the loss of confidence in the pills, the new review of the evidence on the benefits and side-effects, led by Collins, was intended to help doctors, patients and the public make an informed decision about statin therapy, it said.

About a third of those who have already had a heart attack or stroke and would be eligible for statins are not taking them, and that rises to a half among those in the low-risk group. Many do not want to take pills because they do not consider themselves ill, while others worry about side-effects.

The authors say the benefits of taking statins have been under-estimated while the harms have been exaggerated. Treating 10,000 high-risk patients prevents 1,000 heart attacks or strokes and treating 10,000 low-risk patients prevents 500, they say. In the UK, about 2 million people at high risk – because they have suffered a heart attack or stroke – and about 4 million at low risk take statins.

About 40,000 people in each group – a total of 80,000 – avoid potentially fatal heart attacks and strokes as a result, said Collins.

He and his fellow authors stressed that their findings were from randomised controlled trials, which have compared large groups of similar people, some on statins while others were not.

The statins critics generally cite findings from observational studies, Collins said – that is data from people who have been taking statins in the real world, but without a carefully selected comparison group who have not been on the pills. That makes it hard to tell whether any problems are actually caused by the drugs.

There are side-effects, says the review. There is a real risk of myopathy, a neuromuscular disorder which causes muscle damage. One in 10,000 people per year will develop myopathy as a result of this. Another five to 10 people will have a haemorrhagic stroke, which involves bleeding into the brain and 10 to 20 people on statins are diagnosed with diabetes.

There have been claims that as many as 20% of patients have “statin intolerance”, with claims of muscle weakness and pain. At most 10 to 20 in every 10,000 have an increase in such symptoms on the drugs, says the review.

Some GPs have been among the sceptics over statins, but Dr Maureen Baker, chair of the Royal College of GPs, said the study cut through the controversy. “It recognises the benefits that these drugs have for many patients, but also the potential side-effects that any prescribing healthcare professional should be aware of.”

GPs would never take a decision to prescribe statins lightly and should only do it after a discussion with the patient and the medication should be regularly reviewed, she said.

“We hope this research reassures patients who are on statins that in the majority of cases statins are safe and effective drugs – but in most cases where adverse side-effects are seen, these are reversible by stopping taking statins.”

Consultants spoke of struggling to persuade patients that the drugs would help them. “I often meet people who don’t want to take statins yet are happy to take other drugs with greater risks of side-effects, or take supplements with no benefit at all,” said Dr Tim Chico, a consultant cardiologist in Sheffield. “Statins have been unfairly demonised, and this prevents a sensible discussion of the risks and benefits of their use. Statins can cause side-effects, but the chance of developing these is low, while the effects of suffering the heart attack that a statin might have prevented can be fatal or life-long.”

Prof David Webb, president of the British Pharmacological Society, said: “In recent years, those of us who manage the large number of patients at excess risk of heart disease and strokes have been fighting an uphill battle to persuade them to take statins, a class of medicines that have been repeatedly shown to save lives.

“The problem has largely related to concerns about muscle aches and potentially more serious side-effects (muscle damage, diabetes and haemorrhagic stroke) that have been very well publicised on the internet.

“Many patients who have much to benefit from statins, and many of those at more modest risk, have been persuaded not to take them because of exaggerated claims of harm, and some research suggesting that the benefits have been overestimated. It is likely that many lives have been lost, based on a received view that statins are dangerous and ineffective.”

Statins prevent 80,000 heart attacks and strokes a year in UK, study finds

fifty five,000 strokes and heart attacks could be prevented in 2022 with far better blood strain control

Study leader Emanuela Falaschetti from Imperial College London in the Uk said: “Although the rates of diagnosis, treatment method, and management of raised blood stress remain suboptimum in England, our findings are nonetheless a result in for optimism.

“Whereas after the ‘rule of halves’ prevailed—half the general population with large blood stress have been diagnosed, half of individuals detected treated, and half of individuals taken care of controlled—now management in England is better than the rule of two-thirds.

“As a outcome of these enhancements in practice, many hundreds of 1000′s of key cardiovascular occasions may well have been prevented.”

Richard McManus from the University of Oxford in the Uk and Jonathan Mant from the University of Cambridge, wrote in the journal: “Many public wellness initiatives aim to reduce the population burden of hypertension and along with doctors in principal care—who give most hypertension management in the UK—have led to considerable advances in hypertension management and blood strain manage.

“Falaschetti and colleagues’ review offers a welcome illustration of the mixed results of personal physicians and policy makers on a simple but essential danger element. After 50 years of treatment, it appears that the medication are working.”

Around 1 in three people in England have substantial blood pressure, defined as 140mm systolic more than 90mm diasytolic or higher, and it is the single most essential risk aspect for an early death as it brings about strokes and heart attacks.

The improvement in blood stress in the common population is possibly due to a reduction in salt consumption, the researchers explained, as typical consumption has dropped from 9.5g per day in 2000/one to eight.1g per day in 2011. Nevertheless it even now stays above the suggested 6g per day limit.

The staff estimated that if the 2011 image of blood pressure treatment and manage were applied to 1994, amongst 68,000 and one hundred,000 significant fatal and non-fatal cardiovascular occasions would have been prevented in 1994.

fifty five,000 strokes and heart attacks could be prevented in 2022 with far better blood strain control

FDA Approves Novel Merck Drug To Stop Heart Attacks And Strokes

The FDA nowadays approved vorapaxar (Zontivity), Merck’s Merck’s after-troubled platelet receptor antagonist, to minimize the danger of myocardial infarction (heart assault), stroke, cardiovascular death, and revascularization procedures. The drug is accepted for use in people with a background of MI or peripheral arterial illness. The approval represents an wonderful turnaround for a drug that had knowledgeable nearly as several ups and downs as an amusement park roller coaster.

Vorapaxar is the 1st in a new drug class recognized as protease-activated receptor-1 (PAR-one) antagonists. By stopping the capability of platelets to stick collectively and kind blood clots, the drug can support prevent MI and stroke. But it also increases the chance of bleeding, which includes daily life-threatening and fatal bleeding. Simply because the threat of significant intracranial bleeding is specially large in individuals who have had a stroke, a transient ischemic assault, or bleeding in the head, use of the drug is contraindicated in these groups. The drug’s label consists of a boxed warning about the chance of bleeding. The FDA stated the drug will be dispensed with a patient Medication Guidebook.

Vorapaxar appeared to be all but dead a number of years in the past following unacceptably substantial significant bleeding costs had been identified in two huge clinical trials. But hopes for the drug resurfaced with a new examination of one of these trials, the TRA2P trial. In a statement to the press, Ellis Unger, director of the FDA’s Workplace of Drug Evaluation I, mentioned that the trial showed that “in sufferers who have had a heart assault or who have peripheral arterial illness, this drug will lower the risk of heart assault, stroke, and cardiovascular death…  Zontivity lowered this danger from 9.five percent to seven.9 % over a three-yr period – about .5 percent per yr.”

In January the FDA’s Cardiovascular and Renal Medication Advisory Committee voted 10-one in favor of approval for vorapaxar.

FDA Approves Novel Merck Drug To Stop Heart Attacks And Strokes