Taking Statins - Summary
Statins are often prescribed for patients who are at medium or high risk for Coronary Heart Disease. There is sufficient research to date that demonstrates that they lower the risk of subsequently becoming ill with CHD. The risk reduction is typically 25-30% for a subsequent coronary event, in most studies. However, mortality is reduced by less - some numbers are quoted in the 15% range, and some studies do not show any reduction in mortality.
The "Therapeutics Letter" (published by the University of British Columbia, Department of Pharmacology and Therapeutics), April-May-June 2003, determines that 71 patients with cardiovascular risk factors have to take a statin for 3-5 years, to prevent one myocardial infarction or stroke. They conclude that "statins have not been shown to provide an overall health benefit in primary prevention trials".
The implications of this need to be carefully weighed: many people will get the medication, and only a fraction of them will be impacted; they do not necessarily become free of future CHD, but delay its onset. If the mortality risk is reduced by 15%, it implies that the remaining years of one's lifespan will be extended on average by 15%. Whether this justifies the many people taking medication is a personal decision that should be made carefully.
Another aspect that should be considered is that more people are now being prescribed statins when their cholesterol is "borderline" (total cholesterol between 200 and 239 mg/dL, LDL between 130 to 159 mg/dL). This ignores the fact that a high HDL level, if present, could mitigate the impact of high LDL. Also, cholesterol skeptics, a loosely knit group of physicians and scientists who consider cholesterol to only be a minor factor (if any) in predicting heart disease, strongly oppose medication by statins for healthy people. Their reasoning should be weighed carefully!
You can find more information at our Risk Tutorial site.
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Last Modification - September 1, 2008