Wednesday, February 11, 2009

Statins cut risk of death even in healthy people, research claims

The study mentioned below is unbelievably stupid. It is a study of therapeutic compliance masquerading as a study of statins. What it found was that people who take their pills regularly are healthier. But we already knew that compliers were different, regardless of what the pills are! Unbelievable! And since the side-effects of statins can be severe and not easily tolerated, the non-compliers were probably less robust to start with. I could go on and note even more problems with the study (use of very extreme groups, for instance) but why try to kill a dead horse? The citation for the new study is: Shalev, V. et al. (2009) "Continuation of Statin Treatment and All-Cause Mortality". Arch. Intern. Med. 169(3):260-268

Millions more people could be put on statins to prevent a heart attack experts said as new research shows they are more effective than previously thought. A study has found the drugs cut deaths by up to 50 per cent in people without heart disease if they took them daily, the study found.

There have been calls for everyone over the age of 50 to be given drugs to lower the risk of a heart attack but this is controversial as many see it as needlessly medicalising healthy people. Prof Roger Boyle, national director for heart disease and stroke, said the public was against a blanket approach to prescribe statins to everyone over 50 and so instead GPs will this year begin to assess the risk of a heart attack for all over 40s this year. He said the only constraint to the programme was how fast the assessments could be carried out and 'whether the public will accept the change from being a person to being a patient and taking medication long-term'. "The research confirms the benefits of statins throughout the stages of heart disease and it is a powerful indicator of the safety of this kind of treatment," he said.

In the latest study data from almost 230,000 adults with an average age of 57 was analysed by a team in Tel Aviv. Pharmacy records were checked to establish how often patients were taking their drugs. The primary prevention group were followed up to four years and 4,259 people died in that period and the secondary prevention group were followed for five years during which time 8,906 people died. The drugs are supposed to be taken every day and the more compliant people were with the regime the greater the reduction in their chances of dying.

Earlier studies had suggested there was a 12 per cent reduction in deaths or had found no affect at all in healthy people, the paper published in the Archives of Internal Medicine said

The effect was more pronounced in those with higher levels of bad cholesterol at the beginning of the trial and in those who were given high potency statins. Dr Varda Shalev, and colleagues at Maccabi Healthcare Services and Sackler Faculty of Medicine, in Tel Aviv, Israel, wrote in the paper: "The present study demonstrates a strong and independent association between statin therapy and the improved survival of patients with and without coronary heart disease. "The observed benefits from statins were greater than expected from randomised clinical trials, emphasising the importance of promoting statin therapy and increasing its continuation over time for both primary and secondary prevention."

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