MONDAY, June 28 (HealthDay News) -- Despite being used widely to
lower cholesterol levels, statins don't appear to reduce the
chances of death in people at risk of developing cardiovascular
disease, British scientists have found.
Statins are used widely to treat and prevent cardiovascular
disease. They are given both to people with heart disease and -- in
more recent years -- to those who are at risk for heart disease but
who have no history of it.
In people with a history of heart disease, statin therapy is
known to reduce the risk of complications from the illness and
premature death, the British researchers noted. But they said their
new meta-analysis of previously published studies -- along with the
known risks that statins pose to certain people -- calls into
question the benefits of statins to prevent the development of
One U.S. expert said the findings need to be taken in
"Statin therapy has been demonstrated in individual randomized clinical trials and in pooled analysis to prevent fatal and nonfatal cardiovascular events in individuals without established cardiovascular disease," said Dr. Gregg C. Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center at the University of California, Los Angeles.
"In eligible men and women without contraindications, statin therapy -- along with lifestyle modifications-- represents one of the most effective means to prevent myocardial infarction [heart attack] and stroke," he said.
This new analysis examined a number of primary prevention trials
to determine, during the first few years after statin therapy is
initiated, whether there is a reduction in deaths from all causes,
"As expected, with primary prevention studies having only a mean duration of follow-up of 3.7 years, a reduction in all-cause mortality was not observed," he said. "To detect a reduction in all-cause mortality in a primary prevention population, studies of longer duration or confined to only the most potent statins would be required."
This study also shows the safety of statin therapy, even in
apparently healthy people, as "there was no evidence for an
increase in non-cardiovascular mortality," Fonarow said.
The report is published in the June 28 issue of the
Archives of Internal Medicine.
For the study, Dr. Sreenivasa Rao Kondapally Seshasai, from the
cardiovascular epidemiology unit at the University of Cambridge and
Addenbrooke's Hospital, Cambridge, and colleagues pooled data from
11 studies, which included 65,229 participants. In all, 32,623 of
these individuals took statins and 32,606 were taking a
During almost four years of follow-up, 2,793 people died. Among
those who died, 1,447 were taking a placebo and 1,346 were taking
statins, the researchers found. This difference was not
statistically significant, they noted.
Even though the statins were doing their job and the levels of
LDL, or "bad," cholesterol were higher among people taking the
placebo than those taking statins, there was no association between
risk of dying and LDL levels, Seshasai's group found.
Currently, some 33.5 million older Americans, according to the
American Heart Association, are taking a statin or have risk
factors that suggest a need for statin therapy. However, another 11
million older Americans at risk for heart disease may be eligible
for statin therapy, according to the association.
Previous data suggests that people who have cardiovascular
disease benefit from statin therapy. Various studies have found
that these drugs prevent complications from cardiovascular disease
and lower the risk of dying in this population.
However, there is much less evidence that statins lower the risk
of dying prematurely in people without heart disease.
"Current prevention guidelines endorse statin therapy for subjects at high global risk of incident cardiovascular disease as a means to reduce fatal and nonfatal vascular events," the researchers write. "Due consideration is needed in applying statin therapy in lower-risk primary prevention populations," they conclude.
For more information on statins, visit the
U.S. National Library of Medicine.