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(Circulation. 2006;114:1315-1320.)
© 2006 American Heart Association, Inc.

Controversies in Cardiovascular Medicine

The Argument Against the Appropriateness of Over-the-Counter Statins

Philip J. Barter, MBBS, PhD, FRACP; Kerry-Anne Rye, PhD

From The Heart Research Institute and the Department of Medicine, University of Sydney, Sydney (P.J.B., K.-A.R.), and the Department of Medicine, University of Melbourne, Melbourne (K.-A.R.), Australia.

Correspondence to Professor Philip Barter, The Heart Research Institute, 145 Missenden Rd, Camperdown, NSW 2050, Australia. E-mail barterp@hri.org.au

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The availability of statins has revolutionized the management of patients at high risk of having a cardiovascular (CV) event. Statins reduce the risk of future CV events in virtually everyone in whom they are used. The benefit is apparent in those with and without manifest CV disease and is independent of age, gender, and the presence of disorders such as hypertension and diabetes. The benefit also is independent of the baseline level of low-density lipoprotein (LDL) cholesterol. In fact, to date, there is no group (with the possible exception of those with end-stage renal disease) in whom CV risk is not reduced by statin use. Furthermore, the available members of this drug class are well tolerated and have an excellent safety record, with serious adverse effects such as myopathy and liver damage occurring in only a small percentage of people taking these agents.

Response by Gotto p 1320

On the basis of the available evidence base, most current guidelines recommend the use of statins in all high-risk people, with high risk being variously defined as those either with existing CV disease or with a calculated 5-year risk that is comparable to that in people with manifest disease.

Given the evidence of efficacy and safety, it has been suggested that statins should be provided over the counter (OTC) in pharmacies without the need for a prescription to make them accessible to a much wider group of people. This approach has already been adopted in the United Kingdom, where low-dose (10 mg) . . . [Full Text of this Article]