Statins for Primary Prevention of Cardiovascular Disease
Authors: Henock G. Yebyo, Hélène E. Aschmann, Milo A. Puhan
Journal: Annals of Internal Medicine (2019)

Letters2 July 2019Statins for Primary Prevention of Cardiovascular DiseaseHenock G. Yebyo, PhD, Hélène E. Aschmann, MSc, and Milo A. Puhan, MD, PhDHenock G. Yebyo, PhDUniversity of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland (H.G.Y., H.E.A., M.A.P.)Search for more papers by this author, Hélène E. Aschmann, MScUniversity of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland (H.G.Y., H.E.A., M.A.P.)Search for more papers by this author, and Milo A. Puhan, MD, PhDUniversity of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland (H.G.Y., H.E.A., M.A.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0262 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Important comments were forwarded on our recently published article about risk thresholds to start a statin therapy for primary prevention of cardiovascular disease.Dr. Good and his colleagues, referring to the AFCAPS/TexCAPS study (1), suggested that the potency of statins may increase over time. We decided against considering such a time effect because we did not find consistent evidence of such a trend in our data and other systematic reviews (2). Dr. Spence agreed with our assumptions of increased risk for myopathy and diabetes due to statins but questioned the risks for cataract, hepatotoxicity, and hemorrhagic stroke. Dr. ...References1. Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;279:1615-22. [PMID: 9613910] CrossrefMedlineGoogle Scholar2. Collins R, Reith C, Emberson J, et al. Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet. 2016;388:2532-2561. [PMID: 27616593] doi:10.1016/S0140-6736(16)31357-5 CrossrefMedlineGoogle Scholar3. Advera Health Analytics. The Comparative Safety of Cholesterol Lowering (Statin) Medications: An Analysis Utilizing AdverseEvents Explorer. Santa Rosa, CA: Advera Health Analytics; 2014. Google Scholar4. Yebyo HG, Aschmann HE, Yu T, et al. Should statin guidelines consider patient preferences? Eliciting preferences of benefit and harm outcomes of statins for primary prevention of cardiovascular disease in the sub-Saharan African and European contexts. BMC Cardiovasc Disord. 2018;18:97. [PMID: 29776337] doi:10.1186/s12872-018-0838-9 CrossrefMedlineGoogle Scholar5. Djulbegovic B, Hozo I, Mayrhofer T, et al. The threshold model revisited. J Eval Clin Pract. 2019;25:186-195. [PMID: 30575227] doi:10.1111/jep.13091 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland (H.G.Y., H.E.A., M.A.P.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1279. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFinding the Balance Between Benefits and Harms When Using Statins for Primary Prevention of Cardiovascular Disease Henock G. Yebyo , Hélène E. Aschmann , and Milo A. Puhan Statins for Primary Prevention of Cardiovascular Disease Zhen Zhou Statins for Primary Prevention of Cardiovascular Disease Benjamin Djulbegovic and Iztok Hozo Statins for Primary Prevention of Cardiovascular Disease Paul C. Sorum Statins for Primary Prevention of Cardiovascular Disease J. David Spence Statins for Primary Prevention of Cardiovascular Disease Chester B. Good , Inmaculada Hernandez , and Natasha Parekh Metrics Cited byTPGS2k-PLGA composite nanoparticles by depleting lipid rafts in colon cancer cells for overcoming drug resistanceEfficacy of statin treatment based on cardiovascular outcomes in elderly patients: a standard meta-analysis and Bayesian network analysis 2 July 2019Volume 171, Issue 1Page: 74-76KeywordsCardiovascular diseasesConflicts of interestDisclosureHemorrhagic strokeInformation storage and retrievalObservational studiesRelative riskStatinsStatistical distributionsSystematic reviews ePublished: 2 July 2019 Issue Published: 2 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...