Adverse effects were similar for all of the different statins taken except for liver dysfunction, where the highest risks were found for fluvastatin. All of the increased risks persisted during the treatment, but were highest in the first year.
Overall, for every 10,000 high risk women treated with statins, there would be approximately 271 fewer cases of cardiovascular disease, 8 fewer cases of oesophageal cancer; 74 extra patients who experience liver dysfunction; 23 extra patients with acute renal failure, 307 extra patients with cataracts, and 39 extra patients with myopathy. Similar figures were found for men except rates of myopathy were higher. Some of the effects might be due to better detection rates since patients taking statins will consult their doctor more.
The authors said: "At national level, our study is likely to be useful for policy and planning purposes. Our study may also be useful for informing guidelines on the type and dose of statins."
A companion paper by the same researchers, published today in the journal Heart, shows that their newly-developed and validated risk prediction algorithms could be used to identify patients at high risk of adverse events from statins so that they can be monitored more closely. A web calculator suitable for use by doctors can be found at www.qintervention.org
In an accompanying editorial, two senior cardiologists say that, like any intervention in medicine, statins are not entirely free of adverse events, but that when used according to current guidelines, the benefits outweigh the risks.
|Contact: Professor Julia Hippisley-Cox|
University of Nottingham