No Evidence of Adverse Outcomes from Long-Term Statin Therapy

In randomized trials of statin therapy, lowering LDL cholesterol levels by 40 mg/dL during 5 years cut vascular mortality and morbidity by about 25% without affecting nonvascular morbidity or mortality. But observational studies over longer periods have suggested associations between lower LDL cholesterol levels and elevated rates of nonvascular morbidity and mortality –– and elevated risks for some kinds of cancer.

In the British Heart Protection Study (JW Gen Med Jul 30 2002), 20,000 patients at elevated vascular risk were randomized to receive daily simvastatin (40 mg) or placebo. At 5 years, simvastatin recipients had a 23% relative reduction in major vascular events and a 14% relative reduction in overall mortality; the differences betw…