Statins for people at low risk of cardiovascular disease

摘要

The Cholesterol Treatment Trialists' (CTT) Collaborators conclude that, in those at low risk of cardiovascular disease, the benefits of statin therapy outweigh the known risks, and that consequently current guidelines might need to be reconsidered.Despite coming off patent, these drugs represent a substantial cost, and the CTT Collaborators' suggestion therefore has serious economic implications given the size of the population affected. We used a Markov modelling approach to examine the effects of statin therapy over 10 years in a cohort of 3313 Australians who fit these low-risk criteria (aged >50 years, no history of diabetes or cardiovascular disease, and not on antihypertensive or lipid-lowering therapy). Assuming an intervention cost of USdollar236 per year, and established risk reductions for 20 mg simvastatin, the number of non-fatal events prevented by statins in our population sample was 118 per 10 000 population (95% Cl 85-151). The number of fatal events prevented was 12 per 10 000 population (6-21).