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Are Statins Overprescribed for Primary Prevention?

Ann Intern Med; ePub 2018 Dec 4; Yebyo, et al

Statins provide net benefits at higher 10-year risks for cardiovascular disease (CVD) than are reflected in most current guidelines, and the level at which these benefits occur varies by age, sex, and statin type, according to a recent modeling study. Researchers sought to identify the expected risk above which statins provide net benefit. Interventions included low- or moderate-dose statin vs no statin in persons aged 40-75 years with no history of CVD. Outcome measures included 10-year risk for CVD at which statins provide at least a 60% probably of net benefit, with baseline risk, frequencies of and preferences for statin benefits and harms, and competing risk for non-CVD death. Among the findings:

  • Younger men had a net benefit at a lower 10-year risk for CVD than older men.
  • The risk required for net benefit was higher in women.
  • Atorvastatin and rosuvastatin provided net benefit at lower 10-year risks than simvastatin and pravastatin.

Citation:

Yebyo HG, Aschmann HE, Puhan MA. Finding the balance between benefits and harms when using statins for primary prevention of cardiovascular disease: A modeling study. [Published online ahead of print December 4, 2018]. Ann Intern Med. doi: 10.7326/M18-1279.

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