Statins Benefit Those at Low Risk for Vascular Events
(HealthDay News) – Reduction of low-density lipoprotein (LDL) cholesterol with statins is associated with a decrease in major vascular events, even for individuals with a five-year risk of <10%, according to research published online May 17 in The Lancet.
Borislava Mihaylova, DPhil, and colleagues from the writing committee of the Cholesterol Treatment Trialists' Collaboration, conducted a meta-analysis to investigate the effect of statins on individuals at low risk for vascular events. Data were collected from 22 trials of statin vs. control (134,537 participants) and five trials of more vs. less statin (39,612 participants). Participants were categorized into five groups based on their baseline five-year major vascular event risk on control therapy (no statin or low-intensity statin), and the rate ratio (RR) per 1mmol/L LDL cholesterol reduction was estimated. Major vascular events included major coronary events (i.e., nonfatal myocardial infarction or coronary death), strokes, or coronary revascularizations.
The researchers found that there was a reduction in the risk of major vascular events seen with statin-induced reduction of LDL cholesterol (RR, 0.79 per 1mmol/L reduction), which was mainly independent of age, gender, baseline LDL cholesterol, previous vascular disease, and vascular and all-cause mortality. The proportional decrease was at least as big in the two lowest vs. the two highest risk categories, reflecting significant reductions in major coronary events and coronary revascularization in the two lowest categories. For stroke, the risk reduction for those in the risk category of <10% was similar to that of individuals in higher risk categories.
"The present report shows that statins are indeed both effective and safe for people with five-year risk of major vascular events lower than 10 percent and, therefore, suggests that these guidelines might need to be reconsidered," the authors write.
Many of the trials included in this report were funded by the pharmaceutical industry. Several members of the writing committee disclosed financial ties to the pharmaceutical industry.