Cardiovascular disease is the leading cause of death and disability globally, and there have been concerted efforts for decades to prevent and minimize its impact.
Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood.
LDL cholesterol is often referred to as “bad cholesterol”, and statins reduce the production of it inside the liver. According to the World Health Organization, there were 17.9 million deaths from cardiovascular diseases in 2019, representing 32% of all global deaths. Cardiovascular disease is also a leading cause of premature death, causing 38%Trusted Source of deaths before age 70.
Lifestyle interventions are important for preventing cardiovascular disease, with smoking, obesity, diabetes, lack of physical exercise, and excessive consumption of alcohol all increasing the risk of developing cardiovascular disease. Statins are also an important pharmaceutical option for lowering cardiovascular disease in people at risk. It was estimated that more than 173 million people took statins in 2018.
Evidence published in the journal The Lancet in 2010 shows that reducing low-density lipoprotein cholesterol by 1mmol/L with statins reduces the risks of ischaemic heart disease and stroke by 24% to 25%.
Statins reduce the risk of cardiovascular disease by lowering the level of low-density lipoprotein (LDL) cholesterol in the blood. Too much LDL cholesterol can build up as “plaques” in your blood vessels and narrow their diameter. Over time this narrowing can block blood flow to certain organs. If blood flow to the heart is blocked, it can cause a heart attack, and if it occurs in the brain, it can cause an ischemic stroke.
Targeting the right patients with statins is key to gaining the most benefit.
The U.S. Preventive Services Task Force (USPSTF) recently published its recommendation statement for Statin use for the primary prevention of cardiovascular disease in adults in the Journal of the American Medical Association (JAMA). The recommendations were both slightly more conservative but also very similar to existing recommendations by the American College of Cardiology (ACC) and the American Heart Association (AHA).
The new guidance was published following an evidence review that included 22 randomized clinical trials, including additional data from three randomized control trials not included in the last set of guidelines published in 2016.
On the back of this, they have issued three main recommendations for clinicians dealing with patients.
- Statin use would yield moderate benefit for those ages 40-75 with one or more factors that could increase the risk of cardiovascular disease, no history of cardiovascular disease, and an estimated 10-year cardiovascular event risk of 10% or greater.
- Those of the same age with the same risk factors with a 10-year cardiovascular event risk factor of 7.5% to 10% will have a small net benefit from taking statins.
- However, there was not enough evidence to determine whether it’s beneficial to initiate statin use in those older than 75.