The Power of Statins

Facts Believed to be Associated With All Statin Medications:

Adverse events associated with the statin class of pharmaceuticals are thought to occur more often than they are reported- with high doses of statins prescribed to patients in particular. However, ince this class of drugs has existed for use for over 20 years, statins are considered safe and effective for enhancing the clearance of LDL noted to be elevated in the lipid profiles of patients.
Additionally, there is no reduction in cardiovascular morbidity or mortality, as well as an increase in a person???s lifespan, if one is on any particular statin medication for their lipid management over another, others have concluded. So caution should perhaps be considered if one chooses to prescribe such a drug for a patient if they are absent of dyslipidemia to a significant degree, or are under the belief that one statin medication provides a greater cardiovascular benefit over another. In other words, the health care provider should be assured that any statin therapy for their patients is considered reasonable and necessary if the LDL in their patients need to be reduced perhaps at this time with the evidence that exists regarding statins.
Abstract etiologies for those who choose to prescribe statin drugs on occasion for reasons not indicated by these statin drugs- such as reducing CRP levels, or for Alzheimer???s treatment, or anything else not involved with LDL reduction may not appropriate prophylaxis at this point for any patient. All other benefits that appear to have favorable effects in such areas are speculative at this point, and require further research for disease states aside from dyslipidemia, according to many.
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Yet overall, the existing cholesterol lowering recommendations or guidelines should be re-evaluated, as they may be over-exaggerated upon tacit suggestions from the makers of statins to those who create these current lipid lowering guidelines. This is notable if one chooses to compare these cholesterol guidelines with others in the past. The cholesterol guidelines that exist now are considered by many health care providers and experts to be rather unreasonable, unnecessary, and possibly detrimental to a patient???s health, according to others. Yet statins are beneficial medications for those many people that exist with elevated LDL levels that can cause cardiovascular events to occur because of this abnormality. What that ideal LDL level is may have yet to be empirically determined.
Finally, a focus on children and their lifestyles should be amplified so their arteries do not become those of one who is middle-aged, and this may prevent them from being candidates for statin therapy now and in the future, regarding the high cholesterol issue.
Dietary management should be the first consideration in regards to correcting lipid dysfunctions,

Dan Abshear

Astra-Zeneca has a powerful marketing machine touting this study. As andy256 points out, the results are not as dramatic as reported in the news releases. For details, please see my healthy lifestyle blog post: http://advancedmediterraneandiet.com/blog/?p=88
---------Steve Parker, M.D.

The NNT noted in the article does not reflect the NNT in the editorial in the NEJM authored by Dr. Mark Hlatky. Dr. Hlatky notes the following statistics:
"The proportion of participants with hard cardiac events in JUPITER was reduced from 1.8% (157 of 8901 subjects) in the placebo group to 0.9% (83 of the 8901 subjects) in the rosuvastatin group; thus, 120 participants were treated for 1.9 years to prevent one event."
http://content.nejm.org/cgi/content/full/NEJMe0808320
I am puzzled by the incredible differences in the statistics reported between these two articles. A NNT of 25 is very different from an NNT of 120--yes, I do know that the first NNT is for 1 yr and the 2nd reported for 1.9 yrsyrs. The revised NNT for the editorial would be 61 for 1 year, not 25. How does your author arrive at this "new" and improved number?
And the participants had a mean BMI of 28.3; these were hardly "normal" individuals.
Again, reporting that 50% of the Crestor group had fewer heart attacks and strokes is disingenuous. PLEASE provide the Absolute Risk numbers--Not the Relative risk. In this study the rate of cardiovascular incidents fell from 2.8% to 1.6 % with a statin. And the heart attack and strokes decreased from 1.8% to 0.9%. This difference: 1.8% equals 157 of 8901 participants in the placebo group vs 0.9% which equals 83 of the 8901 participants in the Crestor group , thus the touted "50% decrease in events". What this means in terms of NNT is that 120 participants were treated for 1.9 years to prevent one "hard" event.
Neither of these decreases equal a true "50% decrease", as in 50% of subjects received benefit. Reporting the Relative Risk Numbers is misleading.
In addition, Dr. Lee does not note the significant increase in diabetes in the Crestor group: 3.0%, vs. 2.4% in the placebo group; P=0.01. One wonders if the study had completed its scheduled 4 years what the incidence of diabetes would have been, as well as the absolute risks of cardiovascular events. .