New Statins controversy as study compares risks and benefits

Statins may be over-prescribed, warns a new study.

Researchers say the potential risks of taking the cholesterol-busting drugs might outweigh their benefits.

Statins are among the world’s most commonly prescribed drugs, with more than 30 per cent of adults over the age of 40 being eligible for treatment.

They reduce levels of low-density lipoprotein – or ‘bad’ cholesterol – produced inside the liver.

High levels of bad cholesterol can lead to a hardening and narrowing of the arteries and cardiovascular disease (CVD), according to the NHS website.

Doctors prescribe statins to prevent the onset of CVD – the most common killer in Britain.

Most guidelines recommend statins as primary prevention for people without previous CVD when there is up to a 10 per cent chance of them developing it within ten-years.

But whether and how guideline developers weighed harms against benefits is often unclear.

German scientists found the potential risks of statins outweighed their benefits among people whose 10-year cardiovascular disease risk was between 7.5 and 10 per cent – as guideline currently recommend.

The figure was calculated using a computer model to examine the ‘benefits and harms’ of the drug.

But prescribing only for those at higher risk thresholds would mean denying millions of eligible people of the medicine.

University of Zurich researchers evaluated the ten-year CVD risk threshold, at which the benefits of statins outweighed the harms, with separate estimates for men and women of different ages.

The harms were consistently found to exceed the benefits until people were at substantially higher risk of developing CVD than the ten-year threshold recommended by current guidelines.

Among men aged 70 to 75, with no prior cardiovascular disease events, benefits only outweighed harms for those at more than 21 per cent risk of CVD over a ten-year period.

The study’s approach was developed by national Cancer Institute investigators whereby they projected disease and drug-related adverse events (myopathy, hepatic dysfunction, and incident diabetes) over time while accounting for competing mortality.

Study authors included a wide range of adverse events for statin therapy that were largely dismissed in other guidelines, according to the author of an accompanying Yale University School of Medicine editorial.

But the findings may help to inform decision-making for older adults who are more concerned about the harms of treatment.

Study lead author Dr Milo Puhan said: “Most guidelines recommend statins as primary prevention for people without previous cardiovascular disease when the 10-year risk for CVD exceeds 7.5 per cent to 10 per cent, but whether and how guideline developers weighed harms against benefits is often unclear.”

The findings were published in the journal Annals of Internal Medicine.

By Ben Gelblum and Laura Sharman

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