Although statin therapy has proven to lower cholesterol in patients at high risk of vascular events, current guidelines do not recommend use of this therapy in low-risk patients. However, the results of a new study published on May 15 in The Lancet suggest these guidelines may need to be revisited. The study, which looked at data from 27 trials and 174,149 participants, found that "reduction of LDL cholesterol with a statin reduced the risk of major vascular events, largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular and all-cause mortality." Of particular note, the reduction in major vascular events was "at least as big in the two lowest risk categories as in the higher risk categories." For example, in individuals with five-year risk of major vascular events lower than 10 percent, each 1 mmol/L reduction in LDL cholesterol produced an absolute reduction in major vascular events of about 11 per 1,000 over five years. According to the study authors, the benefits of LDL-lowering statin therapy greatly exceed any risks. As such, they suggest that present guidelines governing statin use should be revised to include lower-risk patients. |
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"Clearly selective use of statin therapy in patients at moderate risk of a future CVD event is the prudent thing to do," said Roger Blumenthal, MD, FACC, director of Johns Hopkins Ciccarone Center for Prevention of Heart Disease and past chair of the ACC Prevention of Cardiovascular Disease Committee. "However, better dietary and exercise habits, more laughter and a great sense of humor are the cornerstone of prevention efforts."