By Dr. John Briffa


Before we look at the stats, let’s define the two main settings in which statin drugs can be used in practice:

    1. Primary prevention – use of statins in essentially healthy people in the hope of preventing a first heart attack or stroke.2. Secondary prevention – use of statins in individuals who have a history of cardiovascular disease (e.g. a previous heart attack or stroke) in the hope of preventing another occurrence.

The relative benefits of statins are greater in secondary prevention because the risk of further events and death is significantly higher than in individuals in the primary prevention category. However, in even the most positive secondary prevention studies, typically 30 individuals have to be treated for several years to prevent one death. That’s good if you’re the one from that 30. However, you stand a much better chance, obviously, of being one of the 29 who don’t benefit in this way.

In the primary prevention setting, the numbers are infinitely worse. The most positive studies suggest that more than 100 individuals need to be treated to prevent one death. However, taken as a whole, the evidence suggests that in the primary prevention setting, overall risk of death is not reduced by statins [1]. What this means is that, however many people are treated, not one single life will be saved.

It’s perhaps useful to remember that most individuals on statins fall into the primary prevention category. So, when someone in this category asks me about the appropriateness of statins for them, I explain the NNT issue, as well as the fact that, at best, a hundred or more people like them would have to be treated for several years for one to be saved. But that’s looking at the data charitably. In reality, there is every chance that not a single life will be saved. Then I mention some of the more common side-effects.

After presenting the facts, I ask if they’re keen to take a statin. I don’t remember the last time someone said ‘yes’ in response to this question. And this might help explain why, in statin studies, we hear little about NNTs, despite their importance.

Read the Full Article here:

The Great Cholesterol Con
The Truth About What Really Causes Heart Disease and How to Avoid It
by Dr. Malcolm Kendrick

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