Up until recently, it was widely thought that people could benefit from cholesterol-lowering statin drugs even if they were healthy. About three-quarters of people taking statins don’t have heart disease, but are at risk of getting it in the future.
In a new study, researchers have re-analyzed all the existing research looking at healthy people who were taking statins. Excluding people who already had cardiovascular disease, the researchers found data on more than 65,000 people from 11 trials.
Among 32,606 people taking an inactive placebo treatment, there were 1,447 deaths. Among the 32,623 people treated with statins, there were 1,346 deaths. Although fewer people died while taking statins, statistical tests show that the difference is small enough to have happened by chance.
Studies lasted only a few years, though, so there’s no way of knowing how well statins work in the longer term.
Previous research made the mistake of including people who already had signs of cardiovascular disease, the researchers say. We know statins help people with cardiovascular disease, so bracketing them together with healthy people could give the impression that treatment worked for everyone.
Another issue with the research so far is the JUPITER trial, which was published in 2008, and seemed to show that statins helped healthy people (study participants had normal cholesterol levels, but high levels of a chemical called C-reactive protein, which is a sign of inflammation). A second group of researchers have criticized the JUPITER trial because it was stopped prematurely: a practice that can lead to biased results. It’s a bit like saying you’ll flip a coin and get five heads in a row - then stopping and claiming to win after getting heads the first two times. Stopping a trial early can also miss side effects that take longer to develop. (The JUPITER trial is also discussed here.)
There’s no real debate about whether statins work for people who’ve already had a heart attack or stroke and are taking treatment to prevent a second one. However, if you don’t have heart disease and you’re taking statins, the new research suggests that the benefits might not be as big as previously thought.
Remember, though, that your doctor prescribed statins because he or she thought you were at risk of developing heart problems. Don’t stop treatment without discussing all the options with your doctor. You could ask your doctor about other positive steps you could take to prevent cardiovascular disease, such as changing your diet, doing more exercise, losing weight, or quitting smoking.
What you need to know. In the short term at least, statins don’t seem to benefit healthy people. We can’t rule out a small benefit, though, and we still don’t know whether they work better the longer you take them.
—Philip Wilson, patient editor, BMJ Group
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