Study doubts benefits of universal statin drug use

Reuters - November 28, 2006

Cholesterol-regulating statin drugs slightly lower the risk of heart attack and stroke in people with no history of cardiovascular disease but may do little to reduce their risk of death, a new analysis concluded on Monday.

Statins, the most widely used class of drugs in the United States, are commonly prescribed to lower excessive levels of artery-clogging "bad" cholesterol and to lessen inflammation in blood vessels.

Statins also are believed to stave off other maladies ranging from lung diseases to dementia, so much so that some medical experts have jokingly suggested that the public at large would benefit from putting statins in the water supply.

But the latest study on the subject published in the Archives of Internal Medicine cast doubt on the benefits of prescribing statins to prevent cardiovascular disease in individuals with healthy cholesterol levels.

While statins definitely lessen the risk of heart attacks and strokes in people already at risk due to heart disease or high cholesterol, routine use of such drugs by otherwise healthy adults produces such limited benefits that it may not be cost-effective, the study found.

For example, an analysis of seven previous trials involving nearly 43,000 adults aged 55 to 75 found that the average adult had a nearly 6 percent chance of suffering a heart attack or stroke over a 4 1/3-year period, compared with a 4 percent risk among those who took statins.

"Therefore, 60 patients would need to be treated for an average of 4.3 years to prevent one major coronary event," the study's author, Dr. Paaladinesh Thavendiranathan of the University of Toronto, wrote in the article.

To prevent a single stroke, 268 people would need to undergo statin treatment, and to prevent one nonfatal heart attack 61 would have to take the drugs, he added.

Moreover, statin use did not improve the overall risk of dying from cardiovascular disease or from other causes, the analysis found.

"Even though universal lipid-lowering therapy appears attractive ... further studies are needed to clarify the cost-effectiveness of therapy in this (healthy) group," Thavendiranathan wrote.