January 21, 2011

Statins: No Benefit for Low-Risk Patients?

(Ivanhoe Newswire) -- Cardiovascular disease (CVD) is the most common cause of death, accounting for one-third of the deaths worldwide. According to a new study, there isn't enough evidence to promote the use of statins (cholesterol-lowering drugs) in people with no previous history of heart disease. Researchers believe statins should be prescribed with caution to those at low risk of CVD.

Statins are first line treatments for heart patients, and the benefits are certain, according to the article. However, there is less evidence that statins are beneficial for preventing heart problems in those who have no history of CVD. Given that low cholesterol has been shown to increase the risk of death from other causes, statins may do more harm than good in some patients.

The researchers reviewed data from 14 trials involving 34,272 patients. Outcomes in patients given statins were compared to outcomes in patients given placebos. Combined data from eight trials involving 28,161 patients that provided data on deaths from all causes showed that statins reduced the risk of dying from 9 deaths to 8 deaths for every 1,000 people treated with statins each year. Statins reduced fatal and non-fatal events, including heart attack, stroke and revascularization surgery, as well as blood cholesterol levels.

However, the researchers say that the results of their review are limited by unclear, selective and biased reporting and urge that careful consideration should be given to patients' individual risk profiles before prescribing statins.

"It is not as simple as just extrapolating the effects from studies in people who have a history of heart disease," lead researcher Fiona Taylor, from the Cochrane Heart Group at the London School of Hygiene and Tropical Medicine in London, UK, was quoted as saying. "This review highlights important shortcomings in our knowledge about the effects of statins in people who have no previous history of CVD. The decision to prescribe statins in this group should not be taken lightly."

The researchers point out that all but one of the trials they reviewed were industry-sponsored. "We know that industry-sponsored trials are more likely to report favorable results for drugs versus placebos, so we have to be cautious about interpreting these results," said Taylor. "The numbers eligible for treatment with statins are potentially great, so there might be motivations, for instance, to stop trials earlier if interim results support their use."

SOURCE: Cochrane Systematic Review, published January 18, 2011