Statins for Primary Prevention of Cardiovascular Disease
Authors: Benjamin Djulbegovic, Iztok Hozo
Journal: Annals of Internal Medicine (2019)

Letters2 July 2019Statins for Primary Prevention of Cardiovascular DiseaseBenjamin Djulbegovic, MD, PhD and Iztok Hozo, PhDBenjamin Djulbegovic, MD, PhDCity of Hope, Duarte, California (B.D.)Search for more papers by this author and Iztok Hozo, PhDIndiana University, Gary, Indiana (I.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0261 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their recent article, Yebyo and colleagues claimed to report “the first study to determine 10-year risk thresholds above which the benefits outweigh the harms” related to statin use in CVD (1). However, the authors did not calculate actual thresholds at which treatment with statins is equal to no treatment; they calculated the probabilities of CVD at which the benefits of statins are greater than its harms, or vice versa—a subtle but important difference.We believe that use of a simple decision analytic, benefit–risk threshold model, originally described more than 40 years ago (2) and recently reconceptualized ...References1. Yebyo HG, Aschmann HE, Puhan MA. Finding the balance between benefits and harms when using statins for primary prevention of cardiovascular disease: a modeling study. Ann Intern Med. 2019;170:1-10. [PMID: 30508425]. doi:10.7326/M18-1279 LinkGoogle Scholar2. Pauker SG, Kassirer JP. Therapeutic decision making: a cost-benefit analysis. N Engl J Med. 1975;293:229-34. [PMID: 1143303] CrossrefMedlineGoogle Scholar3. 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: City of Hope, Duarte, California (B.D.)Indiana University, Gary, Indiana (I.H.)Disclosures: Author have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0261. 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 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 J. David Spence Statins for Primary Prevention of Cardiovascular Disease Paul C. Sorum Statins for Primary Prevention of Cardiovascular Disease Chester B. Good , Inmaculada Hernandez , and Natasha Parekh Metrics 2 July 2019Volume 171, Issue 1Page: 73-74KeywordsCardiovascular diseasesConflicts of interestDisclosureRisk managementStatins ePublished: 2 July 2019 Issue Published: 2 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...