The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors

Abstract: http://www.bmj.com/cgi/content/abstract/338/jun30_1/b2376

full article: http://www.bmj.com/cgi/content/full/338/jun30_1/b2376?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Brugts&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT

Daily Mail Article: http://crabsalloverhealth.blogspot.com/2009/07/should-all-over-50s-take-anti.html

Published 30 June 2009, doi:10.1136/bmj.b2376 Cite this as: BMJ 2009;338:b2376

Research

The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials

J J Brugts, doctor¹, T Yetgin, doctor¹, S E Hoeks, epidemiologist¹, A M Gotto,professor, doctor², J Shepherd, professor, doctor³, R G J Westendorp,professor, doctor⁴, A J M de Craen, epidemiologist⁴, R H Knopp, professor, doctor⁵, H Nakamura, professor, doctor⁶, P Ridker, professor, doctor⁷, R van Domburg, epidemiologist¹, J W Deckers, doctor¹

¹ Department of Cardiology, Erasmus MC Thoraxcenter, 3015 GD, Rotterdam, Netherlands, ² Weill Medical College of Cornell University, NY, USA, ³University of Glasgow, Scotland, ⁴ Department of Gerontology and Geriatrics, Leiden University Medical Center, Netherlands, ⁵ Department of Medicine and Northwest Lipid Research Clinic, WA, USA, ⁶ Mitsukoshi Health and Welfare Foundation, Tokyo, Japan, ⁷ Brigham and Women’s Hospital, Boston, MA, USA

Correspondence to: J J Brugts j.brugts@erasmusmc.nl

Objectives To investigate whether statins reduce all cause mortality and major coronary and cerebrovascular events in people without established cardiovascular disease but with cardiovascular risk factors, and whether these effects are similar in men and women, in young and older (>65 years) people, and in people with diabetes mellitus.

Design Meta-analysis of randomised trials.

Data sources Cochrane controlled trials register, Embase, and Medline.

Data abstraction Two independent investigators identified studies on the clinical effects of statins compared with a placebo or control group and with follow-up of at least one year, at least 80% or more participants without established cardiovascular disease, and outcome data on mortality and major cardiovascular disease events. Heterogeneity was assessed using the Q and I² statistics. Publication bias was assessed by visual examination of funnel plots and the Egger regression test.

Results 10 trials enrolled a total of 70 388 people, of whom 23 681 (34%) were women and 16 078 (23%) had diabetes mellitus. Mean follow-up was 4.1 years. Treatment with statins significantly reduced the risk of all cause mortality (odds ratio 0.88, 95% confidence interval 0.81 to 0.96), major coronary events (0.70, 0.61 to0.81), and major cerebrovascular events (0.81, 0.71 to 0.93). No evidence of an increased risk of cancer was observed. There was no significant heterogeneity of the treatment effect in clinical subgroups.

Conclusion In patients without established cardiovascular disease but with cardiovascular risk factors, statin use was associated with significantly improved survival and large reductions in the risk of major cardiovascular events.

© Brugts et al 2009
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