More on Statin drug recommendations

The headline of the Aug 25 "To Your Good Health" column reads: "Over 70? It might be time for a statin!". The case in point: a healthy 71 year-old man with no pre-existing cardiovascular condition was given an estimated 19% risk of having a heart attack or stroke in the next 10 years. The risk would be reduced to 15% if he takes a statin drug, a "reasonable plan" if the patient does not mind taking the medication.  

Because of a paucity of data, previous guidelines had been controversial for the role of statins for the primary prevention of cardiovascular diseases for healthy elderly persons. Confirming Dr Roach's advice, a new observational, retrospective study of VA patients published in the J Amer Med Assoc, July 7, 2020, reported a 20-25% decrease in death rate and a 10% reduction in cardiovascular disease when comparing statin users with nonusers. Limitations noted: it may make 2-5 years for benefits to appear, and the incidence of stroke was unaffected.

Impressive as the statistical results may appear, let's look at the other side of the coin: If one were to extrapolate the case cited by Dr Roach in a population-based analysis, the cost-effectiveness to the individual and to society would be as follows: for 100 healthy elderly individuals prescribed a statin for 10 years, 4 would benefit, while for the other 96, the medication would do nothing. 

Medical statistics are important in making health decisions. But it depends on how you frame your observations.

(Submitted Aug 27, published Sept 4, 2020 in the Gazette Times, Corvallis)