Benefits of Statins Outweigh Risks

To address the current perceptions and misperceptions of statin effects, as often portrayed in the lay literature, these authors comprehensively present randomized, controlled data on the benefits and risks of statin therapy from the Cholesterol Treatment Trialists' Collaboration (NEJM JW Cardiol Feb 2011 and Lancet 2010; 376:1658). Many of the authors have disclosed financial ties to makers of statins.

The authors found that each mmol/L (39 mg/dL) of LDL-cholesterol reduction with statins is associated with a 20% reduction in the rate of major vascular events and a 12% reduction in vascular mortality. Compared with the benefits of statin therapy, the risks “remain small”; the authors conclude that the only serious adverse effects of long-term statin treatment are myopathy, new-onset diabetes, and, probably, hemorrhagic stroke. Treating 10,000 patients for 5 years with standard statin therapies would result in 5 myopathy cases, 50 to 100 diabetes cases, 5 to 10 hemorrhagic strokes, and 50 to 100 symptomatic adverse events like muscle pain.

Hoping to help clinicians and patients decide about statin treatment, the authors note “the public health implications of the failure to recognise the full benefits of using statin therapy and of the exaggerated claims that have been made about the rates of side-effects.” They observe that these claims sidestep an examination of the limitations of less rigorous and reliable sources of evidence.