Drugs that lower fat levels in the blood, called statins, were effective in reducing risk of death, heart attacks and strokes, across a broad range of patient groups.
The benefits were largest in people at highest risk for heart attacks and strokes but those at lower risk also realized some preventive benefits.
In addition, statins did not prove to have significant harmful effects, as the drugs were not associated with increased risk of muscle pain or myopathy, cognitive decline or liver damage.
The analysis was intended to evaluate the benefits and harms of statins in preventing cardiovascular disease in adults. It reviewed results from 19 clinical trials involving 71,344 adults ages 40 to 75 with a mean age of 51 to 66 years old. The trials compared statin therapy with placebo in individuals who had not previously had a heart attack or stroke, but had known risk factors such as high cholesterol, high blood pressure, diabetes or they smoked. The trials included in the systematic data review followed study participants for six months to six years.
The analysis concluded that statin therapy decreased risk of death overall by 14 percent and risk of death from cardiovascular disease by 31 percent. It reduced the risk of stroke by 29 percent and heart attack by 36 percent.
“We found that all groups studied experienced a decrease in risk of suffering a heart attack, stroke, or death, and those at highest risk benefitted the most from cholesterol-lowering drugs,” said the study’s lead author, Roger Chou.
“The majority of the trials used fixed, moderate doses of statins. The number of trials analyzed, including data from the recent HOPE 3 trial with 12,705 participants, provides much needed insight into the value of statin therapy in preventing a first heart attack or stroke, and associated deaths.”
Cardiovascular disease can lead to heart attacks and strokes and is a leading cause of death in the United States, accounting for 1 of every 3 deaths among adults. It is a challenging disease to treat as it can be “silent” until a heart attack or stroke occurs, potentially resulting in sudden death or serious and lasting health consequences.
High cholesterol is a significant risk factor for cardiovascular disease and statin drugs help prevent the formation of cholesterol. These drugs are most effective at lowering LDL, or “bad” cholesterol, but can also help lower triglycerides (blood fats) and raise HDL, or “good,” cholesterol. However, statins are also thought to reduce risk of heart attacks and strokes by stabilizing cholesterol plaques in the blood vessels, and are effective even in persons without highly elevated cholesterol levels.
The USPSTF commissioned this review to inform the development of recommendations on statin therapy for the prevention of cardiovascular disease in adults ages 40 years and older who have not had a prior heart attack or stroke.
The study has been published in JAMA journal.
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