Eligible patients should be started on statins early and keep taking them ‘for life’, say researchers who analysed long-term data from those who took part in the Heart Protection Study.
The 23% drop in major cardiovascular events seen in those allocated 40mg simvastatin in the five-year study persisted for years after, the data shows.
Once the study ended most of the high-risk patients in either placebo or treatment group ended up on statins, but the beneficial effect seen in those taking simvastatin since the start continued for up to 11 years, the researchers found.
And the ‘reassuring’ long-term data in patients aged 40-80 when the trial started showed no increase in cancer incidence, cancer death or vascular death, the Lancet reported.
Dr Richard Bulbulia, consultant vascular surgeon and research fellow at the Oxford Clinical Trial Service Unit said the persistence of benefit seen in those originally allocated simvastatin was ‘remarkable’.
‘The initial results showed the longer you take statins the bigger the benefits. This shows that people who originally got a statin continued to get that benefit.’
He added: ‘The other key message is we now have really reliable data that there is absolutely no hazard up to 11 years.’
‘This is really important if we continue to lower the threshold at which we prescribe statins so people start them at a younger age and are living longer because of them so are going to be on treatment for longer.’
During the post-trial period, self-reported statin use was similar in both groups, rising from about 59% the first year to 84% by the fifth year.
The similarity in statin use in the 17,500 patients for whom long-term data was available also meant LDL-cholesterol concentrations were comparable between the groups.
Dr Terry McCormack, a GP in Whitby and council member of the Primary Care Cardiovascular Society, said: ‘All the evidence we can get is reassuring because there are still people who have doubts, especially patients who will listen to the scare stories.
‘It is what we expected but it’s still good news.’
‘But there is still research that is needed – we need more research in primary prevention and in the very elderly,’ he said.
‘The question is how long do you benefit – it you’re in your late eighties and taking a statin are you actually benefitting from it?’