Statins ‘could benefit many more’
Statins are widely used to minimise the risk of cardiovascular disease in people with high cholesterol.
But researchers at the Universities of Oxford and Sydney say their work suggests the drugs could be of benefit to many more people.
The study is published online by The Lancet.
Statins are already given to around 2.5m people in the UK.
And the government ruled last year that statins should be made available over-the-counter without a prescription at chemists.
But doctors tend only to recommend them to people with high cholesterol.
The researchers analysed detailed results from more than 90,000 participants in 14 trials involving statin treatments.
They found many people presenting with lower cholesterol levels could also benefit from statin treatment.
The people who derived the greatest benefit were those whose cholesterol level was reduced the most by statin treatment – largely regardless of their starting cholesterol level.
Other evidence points to the plaque stabilization effect of statins. Statins decrease cardiac inflammatory markers and result in plaque stabilization.
The only major downside of statins is the occasional patient who notes muscle pain or weakness (checking creatinine kinase does not always identify this syndrom). We certainly prescribe statins for many patients. This article points out clearly that higher doses give greater benefits.
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{ 6 comments… read them below or add one }
While I agree that statins provide benefit, there is still a very real risk of rhabdomyolysis. I had a young patient recently who had his lipitor increased from 10 to 20mg and developed significant rhabdo, requiring hospitalization.
I am very leary of having these medication available OTC, without the requisite monitoring.
Rich
Very positive spin on an article that is unfortunately available only to subscribers, so several important caveats:
It’s a meta-analysis, so very important to look at the number and quality of the studies included;
Are there any financial disclosures or conflicts of interest from the authors?
What is the ABSOLUTE risk reduction and NUMBER NEEDED TO TREAT in the various subgroups for whom they are promoting statin use.
Only those with access to the original article can answer these questions.
Yes, but the number needed to treat for statins is still ~20-25 for many trials. What about other interventions to prevent heart disease that cost less, have fewer side effects, and are more effective – like walking, loosing weight, or quitting smoking.
A question for personal information. What is the absolute probability that a statin will save an otherwise healthy woman’s life? How many years down the row?
It seems to me that the level of acceptable risk should be considerably lower for a drug taken for primary prevention than for a drug taken to treat a condition. For a healthy person it is an issue of a risk of something now vs a probability of benefit in future. Is this difference taken into consideration?
The reduced fractures with statins are because they are housebound from the myalgias. Do the math!
This information about statins and fractures is useless. Statin manufacturers realize the gig is up soon and newer drugs targeting a more root cause of CAD (inflammation) will surpass their effectiveness. When it’s proven the statins just aren’t the cat’s meow for CAD, the statin manufacturers will say “but but but … what about the fractures and all the other “benefits”.
Please. I am going to say that this topic is not worthy of MEDRANTS. You’re too good chap. Stick to real medicine.
Statin use in women? I do not think we know the answers, but As I understand it statins have less documented benefits in women than men.
it’s a big ???? for me as I think their is too much bias as the statin trials are sponsored by Pharmaceauticals and I think bias can lead to under reporting of side effects and generally puts too much a positive spin on things.
I’m concerned by the thoughts of folks like
John Abramson, MD
http://www.managedcaremag.com/archives/0501/0501.pcp_abramson.html
http://www.overdosedamerica.com/comments.php
the truth is hard to discern