Statins for Primary Prevention of Cardiovascular Disease
Authors: Chester B. Good, Inmaculada Hernandez, Natasha Parekh
Journal: Annals of Internal Medicine (2019)

Letters2 July 2019Statins for Primary Prevention of Cardiovascular DiseaseChester B. Good, MD, MPH, Inmaculada Hernandez, PharmD, PhD, and Natasha Parekh, MD, MSChester B. Good, MD, MPHUPMC Health Plan, University of Pittsburgh School of Medicine, and University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania (C.B.G., I.H., N.P.)Search for more papers by this author, Inmaculada Hernandez, PharmD, PhDUPMC Health Plan, University of Pittsburgh School of Medicine, and University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania (C.B.G., I.H., N.P.)Search for more papers by this author, and Natasha Parekh, MD, MSUPMC Health Plan, University of Pittsburgh School of Medicine, and University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania (C.B.G., I.H., N.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0257 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the modeling study by Yebyo and colleagues on the benefits and harms of statins for primary prevention of cardiovascular disease (CVD) (1). Following a sophisticated analysis in several patient cohorts defined by age and sex, the authors concluded that statins confer benefits for patients at higher 10-year CVD risk than the thresholds recommended in current clinical guidelines and benefit–risk thresholds vary by statin type, age, and sex (1). We suspect, however, that the authors' approach probably underestimated the benefits of long-term treatment with statins (1). This is because this modeling study assumed a ...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. Chou R, Dana T, Blazina I, et al. Statins for prevention of cardiovascular disease in adults: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;316:2008-2024. [PMID: 27838722] doi:10.1001/jama.2015.15629 CrossrefMedlineGoogle Scholar3. Bibbins-Domingo K, Grossman DC, Curry SJ, et al; US Preventive Services Task Force.. Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;316:1997-2007. [PMID: 27838723] doi:10.1001/jama.2016.15450 CrossrefMedlineGoogle Scholar4. 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] MedlineGoogle Scholar5. Ridker PM, Danielson E, Fonseca FA, et al; JUPITER Study Group.. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195-207. [PMID: 18997196] doi:10.1056/NEJMoa0807646 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: UPMC Health Plan, University of Pittsburgh School of Medicine, and University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania (C.B.G., I.H., N.P.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0257. 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 J. David Spence 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 Henock G. Yebyo , Hélène E. Aschmann , and Milo A. Puhan Metrics Cited byMental Stress and Its Effects on Vascular HealthThe endothelium is a key player in the vascular response to acute mental stress 2 July 2019Volume 171, Issue 1Page: 72KeywordsCardiovascular diseasesClinical trialsDisclosureRandomized trialsStable coronary artery diseaseStatins ePublished: 2 July 2019 Issue Published: 2 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...