Rolling the statin dice

Here we go again. On TV, a 60-second breaking news: the use of cholesterol-lowering drug statin would cut the risk of heart attacks and strokes by more than 25% in older individuals who have some, but not a particularly high, risk for cardio-vascular disease. After comments from experts, viewers are left with the impression that it’s a good thing to consider.

Here are the results of the study cited, published in the New England Journal of Medicine (April 2, 2016): Over the 5 year-duration of the study, the group who took rosuvastatin had a disease rate of 3.7 - 4.4%, compared to 4.8 - 5.7% among those who received a placebo drug. This means, approximately, that if 100 patients take a statin for 5 years, we would see a beneficial effect of the drug in 1 patient.  The study found no difference in the rate of fatal heart attacks.

The art and science of medicine is complicated, and I am not writing to dispute expert recommendations. I just want all of us to be aware of how medical statistics should be understood. It sounds good that a drug can cut the relative risk of illness by 25%. The other side of the coin, however, is the number of individuals needed to treat to achieve that statistical result. Rolling the statin dice, 99 out of 100 would have no benefit taking the drug. Add to the equation the cost and side effects of the medication, then, consumers, beware.

Chinh Le, MD

(Published in the Gazette Times, Corvallis, OR, April 8, 2016)