{"id":6065,"date":"2011-01-19T16:02:15","date_gmt":"2011-01-19T21:02:15","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=6065"},"modified":"2011-07-19T17:44:38","modified_gmt":"2011-07-19T21:44:38","slug":"review-raises-questions-about-statins-for-primary-prevention","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/01\/19\/review-raises-questions-about-statins-for-primary-prevention\/","title":{"rendered":"Review Raises Questions About Statins for Primary Prevention"},"content":{"rendered":"<p><a href=\"http:\/\/www2.cochrane.org\/reviews\/en\/ab004816.html\">A <\/a><a href=\"http:\/\/www2.cochrane.org\/reviews\/en\/ab004816.html\">Cochrane<\/a><a href=\"http:\/\/www2.cochrane.org\/reviews\/en\/ab004816.html\"> Review<\/a> raises troubling questions about the evidence base supporting the use of statins for primary prevention. The Cochrane reviewers analyzed 14 randomized trials including 34,272 participants and found that statins were associated with significant reductions in overall mortality, fatal and nonfatal CV endpoints, and revascularization procedures. The reviewers found no evidence of harm.<\/p>\n<p>However, the authors found &#8220;evidence of selective reporting of outcomes, failure to report adverse events and inclusion of people with cardiovascular disease.&#8221; They concluded that &#8220;only limited evidence showed that primary prevention with statins may be cost effective and improve patient quality of life. Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk.&#8221;<\/p>\n<p>In\u00a0<a href=\"http:\/\/www.thecochranelibrary.com\/details\/editorial\/983199\/Considerable-uncertainty-remains-in-the-evidence-for-primary-prevention-of-cardiovascular-disease-by-Carl-Heneghan.html\">an accompanying editorial<\/a>,\u00a0Carl Heneghan discusses the limitations of the trials under review, noting, among other limitations, that the power calculations in most of the trials were based on composite outcomes, that selective reporting of outcomes occurred in some trials, and that some trials reported no adverse outcomes at all. He concludes that &#8220;the most effective and cost-effective intervention for primary prevention in adults at low risk currently remains unclear&#8221; and argues that it is &#8220;unwise to use such studies to determine the overall benefits and harms to the population at risk and drive policy.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A Cochrane Review raises troubling questions about the evidence base supporting the use of statins for primary prevention. The Cochrane reviewers analyzed 14 randomized trials including 34,272 participants and found that statins were associated with significant reductions in overall mortality, fatal and nonfatal CV endpoints, and revascularization procedures. The reviewers found no evidence of harm. [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[665,584],"class_list":["post-6065","post","type-post","status-publish","format-standard","hentry","category-prevention","tag-primary-prevention","tag-statins"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/6065","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=6065"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/6065\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=6065"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=6065"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=6065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}