Study recommends statins for healthy people at risk of heart disease

Statins (e.g. atorvastatin (Lipitor^®), pravastatin (Lipostat^®; Bellprav^®, Bystat^®, Cholstat^®, Lipaprav^®, Pravamel^®, Pravat^®, Pravitin^®) etc.) should be given to people without established cardiovascular disease but with risk factors such as high blood pressure and diabetes, concludes a study published in the British Medical Journal (4^th July, 2009).

Cardiovascular disease is the leading cause of death and disability in the Western world. The benefits of statin therapy in patients with established cardiovascular disease (known as secondary prevention) have been clearly demonstrated, but it is still not clear whether treating lower risk people without established disease (known as primary prevention) would also be worthwhile.

The benefit of treating people aged over 65, women, and those with diabetes is also uncertain.

So an international team of researchers investigated whether statins reduce deaths and major cardiovascular and cerebrovascular events, such as heart attacks and strokes, in people without established heart disease.

They analysed the results of ten large trials involving over 70,000 patients. All the trials compared statin therapy with placebo or control group and tracked patients for an average of four years. Differences in study design and quality were taken into account to minimise bias.

Compared to controls, statins cut deaths from all causes by 12% and cut the risk of major events by 30% in patients without established heart disease.

No significant treatment differences were found between men and women, elderly and young patients, and those with and without diabetes. There was also no evidence of an increased risk of cancer with statin therapy.

These results are very much in line with previous studies on the effects of statins in secondary prevention, say the authors.

From the current data, it is not possible to exactly define one group of people who would benefit most from long term statin use, but they suggest that men over 65 years with risk factors, or older women with diabetes and risk factors, constitute the highest risk group.

Further work is needed to improve the identification of these people and to accurately assess their risk. But, given the favourable of long term statin treatment, it would be wrong to deny these benefits to people at increased risk for cardiovascular disease, they conclude.