Health adults can take statins as a primary prevention to avoid major cardiovascular events, a new study reveals today.
Researchers writing in The BMJ say statins are associated with a small increased risk of side effects in patients without a history of heart disease, but these effects are mild compared with the potential benefits.
They say their findings suggest the benefit-to-harm balance of statins for adults without heart disease is generally favourable.
For people with heart disease, the benefits of statins far outweigh the risk of side effects, such as muscle weakness and stiffness.
However, recent guidelines have recommended wider use of statins for primary prevention, so a team of UK and US researchers examined the associations between statins and adverse events in adults without a history of heart disease, and how they vary by type and dose of statins.
They analysed the results of 62 randomised controlled trials with 120,456 participants, whose average age was 61, and 40% of whom were women.
They were followed up for an average of 3.9 years and the researchers found that statins were associated with a slightly increased risk of self-reported muscle pain, liver and kidney problems, and certain eye conditions such as cataracts, but were not associated with clinically confirmed muscle disorders or diabetes.
They say these risks equate to 15 more instances of muscle symptoms, eight more liver events, 12 more kidney events, and 14 more eye conditions per 10,000 patients treated for a year.
However, these increased risks did not outweigh the reduction in the risk of major cardiovascular events.
They said statins prevented an estimated 19 heart attacks, nine strokes, and eight deaths from cardiovascular disease per 10,000 patients treated for a year.
This, they add, suggests that the benefit-to-harm balance of statins for primary prevention of cardiovascular disease is favourable.
Analyses by type of statin showed that atorvastatin, lovastatin, and rosuvastatin were associated with some adverse events, but there were few significant differences between the statins.
Although the researchers point to some limitations in trial design that may have led to events being underestimated or more severe long-term events being missed, they say the low risk of adverse events caused by statins “should reassure patients and physicians that the potential harms of statins are small and should not deter their use for primary prevention of cardiovascular disease”.
Cai T, Abel L, Langford O et al. Associations between statins and adverse events in primary prevention of cardiovascular disease: systematic review with pairwise, network, and dose-response meta-analyses. The BMJ 15 July 2021
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