with any medication the question of whether to take it, is whether the benefits outweigh the harms. One of the issues with statins is that they are very heavily marketed by the pharmaceuticals, and it is not always clear where the marketing ends and the science begins.
Statins have been widely promoted for use in primary prevention - i.e. before you get the disease based on your risk profile. In this case it's heart disease they want to prevent and the primary risk factor is raised cholesterol level.
What is true of every Statin study is that if you take them they reduce your risk of heart disease. However Statins when used in primary prevention make no difference whatsoever to overall mortality scores for people without diabetes. Statins stop you dying from heart disease, but cause you to be more at risk of dying from something else - it is likely that something else is violence/accident.
So....
In theory then if you take a group with a very high risk of heart disease, the benefits of the statin should outweigh the risk of excess mortality from other causes.
This is the aim of the CARDS study. This is good large (supposedly) randomised double-blinded controlled trial - the gold standard of medical evidence.
it took a large group of people with type 2 diabetes average age 62 years with at least 1 risk factor for heart disease. They randomly split them up into treatment and placebo, and then followed them to see what would happen.
this is where the science splits from the press releases...
I have included a PDF summary of the results of the CARDS
http://www.rxfiles.ca/acrobat/Lipid-Q&A-CARDS.pdf
The results are seemingly spectacular (and for heart disease they are pretty good).
The time to first event is confusingly stated as a percentage, however Statins will reduce your risk of dying from heart disease, suffering a heart attack, needing surgery due to artery disease, or having a stroke. Ignore the RRR, and instead look at the NNT (Number needed to treat).
The Number Needed to Treat is 32, which is good for a statin (typically it is around 50). This means for YOU, that if you are around 60 with type 2 diabetes and at least 1 risk factor, taking a statin has a 1 in 30 chance (3%) of stopping you suffering an adverse event over 4 years.
If you are anybody else, then, it's anybody's guess.
now gaze down to the overall mortality figures....
don't be lured by the percentages, gaze along to the RRR column, and note the NS placed there. NS in this case stands for not significant. That's right.
the slight reduction in overall mortality for the statin group, could very easily have arisen by chance.
and from the article linked to by Tony.
Quote:
and the overall mortality rate for Lipitor patients was
27 percent lower than for those on placebo.
|
they unfortunately can't claim the reduction, it wasn't significant - but would you know that from reading the press release?
so...
yet again a Statin trial fails to show any benefit to overall mortality.
question?
why did they end a double-blinded trial early when, if they let it run longer those overall mortality figures might have reached significance?
I guesss you pays your money and takes your choice
