How best to use statins to prevent heart disease, stroke death

02/22/2010 - Articles

How best to use statins to prevent heart disease, stroke death

By: Susan Aldridge, medical journalist, PhD


Statins are cholesterol-lowering drugs which have been shown to reduce the rates of death from heart attack and stroke in those at high risk. But there are two issues around statin use that need to be resolved. First, people tend not to persist in taking their statins long-term – that is, only 50% of patients prescribed them are still taking statins after five years. Second, we don’t really know who ought to be taking statins – should they be offered to people at medium or low risk of heart disease as well? Or maybe everyone should receive them – just in case?

A study from doctors in the UK sheds offers new direction on how statins should be used. They carried out a big review on statin use in normal practice and clinical trials. Then they looked at a big Australian study of 38,000 patients, looking at their various risk thresholds and outcomes in terms of heart disease. All this data was put together by computer modelling to see which is best – get high risk patients to stick to their treatment, or offer statins to more patients. They conclude that if there were a 50% increase in the number of patients sticking to their statin prescription, it would ward off twice as many stroke and heart attack deaths as would offering statins to a wider range of patients. Therefore, they conclude, it is better to concentrate on the high risk patient and do all possible to help them take their statins long-term.



Shroufi A and Powles J Adherence and chemoprevention in major cardiovascular disease: a simulation study of the benefits of additional use of statins Journal of Epidemiology and Community Health Online First 2010: doi 10.1136/jech.2009.091033


Created on: 02/22/2010
Reviewed on: 02/22/2010

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