Statins - worth it for people with no history of heart disease?

in its new guidelines (http://guidance.nice.org.uk/CG/WaveR/123) , NICE have lowered the bar for recommended statin use from people with a 1 in 5 risk of developing a CVD to 1 in 10.

Personally, (and not with my editor hat on) I wonder if such a move is justified. Being doing some research and the NNT appears to be quite, well, a bit rubbish.

(sorry - jargon buster - NNT = Number Needed to Treat = the amount of people you would have to treat before one person gained any benefit; ideally a drug's NNT should be as close to 1 as possible)

One analysis put the NNT for people with no history of heart disease as high as 98 (http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/) - while the risk of side effects could be as high as 1 in 10

If I was offered statins myself I would probably turn them down and hit the gym instead

5 Replies

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  • I've been wondering about this too. The NNT is far higher than the number needed to harm. The draft guideline does talk about optimising lifestyle factors first (exercise, diet, smoking etc) but then says people with 10% risk should be offered statins. NICE says it tells doctors to offer something when they expect the vast majority of people to accept the treatment. It does then refer to an NHS patient decision aid (which we were involved in creating) which is good - at least people should get some help in assessing the risks and benefits. I'm also a bit flummoxed by the suggestion that GPs should consider offering statins to everyone over 85, on the grounds that their age alone means they have a 10% risk of cardiovascular event. Again from a personal point of view, if I was 90 and a GP offered me a drug that'd probably give me a stomach upset but might help me last to 93, I think I'd skip it.

  • Great to read a neat description of NNT

  • where can I get informed values for recommended levels of blood lipids

  • Seems to me that far too many people are already on statins, never mind giving them to more people.

  • Studies repeatedly show that statins are only beneficial to about 6 in 1000 people, yet relative percentages are usually quoted to exaggerate the perceived effectiveness.

    Don't get me wrong, for those people I'm sure statins appear vital, however if the true benefit of statins is their anti-inflammatory properties, there are much safer, more effective alternatives.

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