Statin Guidelines Questioned
Current guidelines for prescribing cholesterol-lowering drugs called statins restrict their use to patients whose 10-year risk of a major vascular event is at least 20%. Now the authors of a new study are calling that rule into question. MedPage Today reports that according to Borislava Mihaylova, MSc DPhil and colleagues on the Cholesterol Treatment Trialists' (CTT) Collaborators writing team, about half of all vascular events occur in those without previous cardiovascular disease. This statistic, along with the fact that more affordable generic statins are becoming available, suggests that "guidelines might need to be reconsidered" to include lower-risk individuals.
The team conducted a large meta-analysis which showed that statins may provide substantial benefit for primary prevention. In the five baseline risk groups in the study, there was a 21% reduction in the relative risk of major vascular events and all-cause death. Age, baseline LDL (the "bad" cholesterol") or previous cardiovascular disease did not significantly alter the results. For those with no history of heart disease, statins reduced the risk of vascular and all-cause mortality by 15% and 9% respectively.
MedPage Today also reports that data from the trials did not show an increase in cancer incidence or cancer death. In addition, adverse events associated with statin therapy such as myopathy, rhabdomyolysis, diabetes, and hemorrhagic stroke were found to be well within the bounds of benefit-versus-risk ratio, the researchers said.