Heart Health and Hypertension: How Statins and Amlodipine Heavily Prescribed in the UK

Over the last decade, two names have consistently topped the NHS prescription charts: atorvastatin and amlodipine. These heart-related medications have become cornerstones in preventing heart attacks, strokes, and managing high blood pressure.

In fact, by 2024–25, medications for heart and circulation problems made up 30% of all prescriptions in England’s community healthcare system. That’s nearly 380 million prescription items-a massive slice of the NHS’s £11.2 billion annual prescription spend.⊃1;

But what’s behind this trend? Let’s break it down.

What Are Statins and Why Are They Everywhere?

Statins are medications that lower cholesterol levels in the blood. High cholesterol can lead to clogged arteries, which increases the risk of heart attacks and strokes.

Atorvastatin, the most commonly prescribed statin, is now the most dispensed medicine in England. In 2024–25, over 73 million prescriptions for atorvastatin were issued-up from 59 million just two years earlier. ^1,2

Why the sudden rise?

• More people are eligible. NHS guidelines have changed to allow more people, even those at moderate risk, to be prescribed statins as a preventative measure. ⁴
• It works. Long-term statin use reduces the risk of stroke by 17% and major heart problems by up to 60%. ⁶

This strategy is about prevention-catching cardiovascular risk early and treating it before serious issues develop.

Five Million People in England Take a Statin

By 2023–24, over five million people in England were taking a statin or ezetimibe, another cholesterol-lowering drug. That’s nearly triple the number from 2015. ⁴

Statins are now viewed not just as treatment, but as a public health tool to:

• Prevent thousands of strokes and heart attacks
• Reduce health inequalities (since heart disease is more common in deprived areas)
• Improve long-term health outcomes

Helen Williams, the NHS’s National Clinical Advisor for Heart Disease Prevention, put it clearly:

“Statins are a key part of plans to help prevent thousands of heart attacks and strokes, reduce health inequalities, and make best use of NHS resources.” ⁴

What About Amlodipine? The Go-To for High Blood Pressure

Amlodipine is a type of calcium channel blocker used to lower high blood pressure (hypertension). It works by relaxing blood vessels so the heart doesn't have to work as hard to pump blood.

In 2022–23, amlodipine was the second most prescribed cardiovascular drug-just behind atorvastatin-with nearly 35 million prescriptions. ³

Why is it so popular?

• It’s often first-line treatment for high blood pressure.
• It’s especially useful for older adults and people who can’t tolerate ACE inhibitors (like ramipril or lisinopril).
• It works well for patients of African or Caribbean descent, who often respond better to calcium channel blockers.

Together, They’re Changing the Way the NHS Tackles Heart Disease

Statins and amlodipine have become a powerful duo in the fight against cardiovascular disease (CVD)-still the leading cause of death in the UK. However, more should be done to encourage lifestyle changes. We must rely less on drugs to change our physiology, and instead live healthier lives. Simply exercising more and eating less would, in most cases, reverse many of the conditions that is treated by statins and blood pressure drugs. 

The NHS’s approach:

• Earlier identification of those at risk of heart disease and stroke
• More widespread prescribing of preventive medications
• Regular follow-ups in primary care (via GPs and community clinics)

Rather than wait for a health crisis, the NHS now takes a “prevent it before it happens” approach-one that relies heavily on medicines like atorvastatin and amlodipine.

Side Effects: What Patients and Clinicians Should Know

Like all medicines, statins and amlodipine can cause side effects. Most are mild, but some can impact physical activity, mobility, and recovery.

Statin Side Effects:

• Muscle pain or cramps (the most common side effect)
• Weakness or fatigue (especially during exercise)
• Rarely, liver enzyme changes or memory issues

Amlodipine Side Effects:

• Swollen ankles or legs (oedema)
• Dizziness or light-headedness (especially when standing up)
• Headaches or flushing

Some hospital doctors have questioned whether "stat dose" amlodipine (high doses given all at once) is appropriate in acute settings.⁷ But in primary care, it's widely used for long-term control.

Why This Matters for Physiotherapists and Rehab Teams

Physiotherapists are now more involved than ever in treating patients with long-term conditions like high blood pressure and high cholesterol. Understanding the effects of cardiovascular drugs helps physios create safer, more effective treatment plans.

Here’s how medications can impact therapy:

• Statins may cause muscle aches that patients confuse with injury or overexertion.
• Amlodipine can cause leg swelling or dizziness-important to consider during walking, balance, or mobility work.
• Patients on heart medications often have lower cardiovascular risk during exercise, meaning rehab may be safer and more productive overall.

Physiotherapists must now routinely review medication lists, flag concerns to prescribers, and adjust treatment accordingly.

Looking Ahead: A National Strategy for Heart Health

The rise in atorvastatin and amlodipine prescribing isn’t random-it’s part of a nationwide plan to improve heart health outcomes and reduce pressure on hospitals.

What this means for the future:

• Earlier prevention = fewer hospital admissions
• More coordinated care between GPs, pharmacists, physios, and specialists
• A bigger role for allied health professionals in long-term cardiovascular care

The NHS is clearly betting on medicines to reduce the burden of heart disease-and that approach is already visible in prescription data.

Statins and amlodipine are now some of the most widely used medications in the UK, reflecting the NHS’s commitment to preventive care. In just a decade, we've gone from treating heart disease reactively to tackling it head-on with medication and early intervention.

For healthcare professionals-especially physiotherapists-this shift means greater involvement in managing patients with chronic cardiovascular conditions. Staying informed about the effects, benefits, and challenges of these drugs is essential for delivering safe, tailored, and effective rehabilitation.

As prescription trends evolve, so too must the way we support patients-on and off medication.

References

1. NHS Business Services Authority. (2025). Prescription Cost Analysis England 2024/25. NHSBSA. https://www.nhsbsa.nhs.uk/statistical-collections/prescription-cost-analysis-england

2. NHS Business Services Authority. (2023). Prescription Cost Analysis England 2022/23. NHSBSA. https://www.nhsbsa.nhs.uk/statistical-collections/prescription-cost-analysis-england

3. Chemist+Druggist. (2023). Prescription costs up 8% to over £10bn in England. C+D News. https://www.chemistanddruggist.co.uk/CD136801/Prescription-costs-up-8-to-over-10bn-in-England

4. National Institute for Health and Care Excellence (NICE). (2024). More people are benefitting from NICE-recommended statins. NICE News. https://www.nice.org.uk/news/article/more-people-are-benefitting-from-nice-recommended-statins

5. Pharmaceutical Journal. (2024). Statin prescribing in England at record high. The Pharmaceutical Journal, 4 November 2024. https://pharmaceutical-journal.com/article/news/statin-prescribing-in-england-at-record-high

6. Wikipedia contributors. (2024). Statin. Wikipedia, The Free Encyclopedia. https://en.wikipedia.org/wiki/Statin