Review: Statins should be used with "caution" in patients at low risk of cardiovascular disease

An analysis published Wednesday in The Cochrane Library suggested that statins should be prescribed with "caution" in people at low risk of cardiovascular disease, as there is no "strong evidence" to indicate the drugs reduce coronary heart disease in this population. "This review highlights important shortcomings in our knowledge about the effects of statins in people who have no previous history" of cardiovascular disease, commented lead researcher Fiona Taylor, adding that "the decision to prescribe statins in this group should not be taken lightly."

The review was based on data from 14 clinical trials involving 34 272 patients that compared the use of statins with either standard care or placebo. The researchers found that combined data from eight trials involving 28 161 patients, which provided data on deaths from all causes, showed that statins prevented one death for every 1000 people treated annually with statins. The compounds also reduced fatal and non-fatal events, the scientists noted, including myocardial infarction, stroke and revascularisation surgery, as well as lowered blood cholesterol levels.

Shah Ebrahim, who co-authored the study, noted that among people at a lower risk of cardiovascular disease statins could do more harm than good. He noted that "there are some small trials that show evidence of cognitive lapses and depression," and previous studies have also linked the cholesterol-lowering agents to liver problems, acute kidney failure and muscle damage.

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