The benefits of statins on extending life and postponing mortality
The benefits of statins are numerous, and they are important drugs for the prevention of atherosclerotic conditions such as a stroke, myocardial infarction or limb ischaemia (Kristensen et al. 2015). In other words, statins are effective drugs in delaying or preventing the onset or recurrence of heart disease. Statins are often given to people once they have already been diagnosed with cardiovascular disorder (secondary prevention), or have suffered a stroke/heart attack. They can also be given to people before they’ve ever suffered from cardiovascular disease (primary prevention), however, and are provided in a preventative type capacity. In addition, statins are widely prescribed, and are in fact one of the most widely prescribed drugs overall.
The question is, despite their widespread use, how effective are statins in reducing one’s risk for heart related mortality? This study by Kristensen et al. 2015 sought to answer that question.
Kristensen et al. looked at 11 research trials that each investigated 1000 individuals or more. The participants in each trial were either issued a statin or a placebo/no treatment. Moreover, they had to be treated for a minimum of two years to be included. The cut off from treatment that each patient received varied between 2 & 6 years. Kristensen et al. then highlighted the difference in the number of people that died in each treatment group i.e. those given statins compared to those given placebo’s and, more notably, the estimated number of ‘extra’ days the statin-takers lived for compared to the non-statin takers.
Are statins good for you?
The results showed that death was postponed between 5 and 19 days in (statin taker) participants from trials looking at primary prevention – those taking statins before actual diagnosis of atherosclerosis and with signs of elevated risk – and between 10 and 27 days in (statin taker) participants from trials looking at secondary prevention – those taking statins after diagnosis of atherosclerosis.
What does this mean? First and foremost, a 2 to 6 year period of statin consumption extended an individual’s life by 19 days (tops) if it were for primary prevention and 27 days (tops) if it were for secondary prevention. The thing to remember here is that the number of days of postponement ignores the fact that statin consumption would continue long after the investigation finishes, and therefore the individual may continue to accrue additional benefits of statins over a longer duration of treatment. So this only reflects the benefit gained from a certain period (2 – 6 years) of statin consumption. Still, the number of days estimated to be gained from statin therapy is minimal.
Secondly, statin use appeared somewhat more effective for secondary prevention – once someone is already suffering from heart disease – than for primary prevention. This suggests that stating therapy is perhaps more warranted for those individuals who have already been diagnosed with an atherosclerotic condition, compared to those who have, as yet, not be diagnosed with heart related disease.
The benefits of statins
The authors of the study therefore suggest that statin treatment results in surprisingly small average gain in overall survival across a 2 – 6 year period. They then suggest that for patients whose life expectancy is already limited, or for those who suffer from side effects due to statin consumption, statin therapy should not be the only course of action.
It’s worth keeping in mind that in all trials, bar one, a person’s risk of dying went down significantly. It is also worth keeping in mind that non-fatal endpoints were not investigated. So statins may prevent other diseases/complications, aside from actual death, although that wasn’t researched in this trial. However, the overwhelming feeling from these results is that statin therapy has a very minimal effect on increasing life/preventing death. Moreover, sustained statin therapy is required to produce only a margin of gain.