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Primary prevention statins benefit 'may be marginal’ for healthy patients, says study

The benefits of statins for primary prevention in healthy patients is unclear and in some cases a ’waste of healthcare resources’, according to a study in the BMJ.

The study from the National University of Ireland, Galway, which analysed primary prevention data for people taking statins for one to five years, found a significant reduction in death from any cause, vascular deaths and coronary or vascular events.

However, it concluded most outcomes were not statistically significant when the baseline risk of developing a cardiovascular disease was factored in, raising uncertainty about the benefits of statins for primary prevention.

Paula Byrne, one of the researchers in the study, argued that the use of statins for primary prevention ‘may be an example of low value care and, in some cases, represent a waste of healthcare resources’.

Although the benefits of statins among healthy patients remains unclear, the study also showed that the proportion of over-50s eligible for statins increased from 8% in 1987 to 61% in 2016 due to a change in guidelines on cardiovascular disease.

This meant increasingly lower risk people became eligible for treatment.

But the authors argued that none of those patients classified as low or moderate risk in primary prevention would reach acceptable levels of risk reduction to justify taking a daily statin.

The prescription, use, and reimbursement of statins in primary prevention, they said, 'warrants more careful consideration’. They added that overuse and low value care ‘should become integral to policy making and resource allocation decisions’.

Responding to the study, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: ’Evidence has shown that statins are safe drugs and an effective preventative measure against heart conditions when prescribed and used appropriately.

’Nevertheless, the College has previously voiced concern around lowering the threshold for initiating statin therapy, which has significantly increased the number of patients eligible, due to the potential for overdiagnosis.

’Patients certainly have the right to question whether statins are the best course of therapy for them – as they do with any prescribed medication – and as with any long-term medication, it’s important that regular reviews are undertaken to determine if they are proving beneficial for the patient, based on their current circumstances.

’As with all new research, it is important that the findings are considered as clinical guidelines are updated and developed, in the best interests of our patients.’

It follows the news that the range of professions that will be able to prescribe ‘low-risk’ medicines is set to increase

Readers' comments (4)

  • Fascinating although I think most GPs have known this for some time. NICE encourages us to prescribe statins at a 10% risk threshold which puts GPs in a difficult position and uses up vast amounts of clinical time whilst waiting times for GPs are going up. What I want to know is why are so few people scrutinising the authors of these guidelines which inevitably become a legal standard the moment a complaint comes in?

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  • So how many GP's stop statins at the five year mark, after which we are practising evidence hoped for,supposed or fantasy medicine.

    So statins are effective,are they,quite how effective would that be then,doctors tend to use the term NNT,what level of NNT are you claiming.

    A statin lowers your 10% risk to 9.9 %.

    As to side effects,read J Le Fanu,especially the line about a GP not allowing his patient to stop the statin

    A statin holiday is surely one of the most basic clinical tests.

    The college has been insufficiently vocal and critical on this issue,a trend which appears to be continuing

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  • And yet we continue to "spaff" a load of money on NHS Healthchecks as if they are a good thing!!

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  • HS-L: "’s important that regular reviews are undertaken..."

    But if the problem is that primary care time is being wasted on poor-value interventions, regular reviews will only worsen the situation.

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