Statins are again coming under fire in the popular media with reports like “ Statins Age you Faster”.
This comes following a report published in the American Journal of Physiology which states that statins’ “…impact on other biologic properties of stem cells provides a novel explanation for their adverse clinical effects.”
The study conducted on stem cells found that those exposed to statins changed into immune cells at lower levels than those that weren’t exposed to statins.
The authors believe that this might be beneficial to the prevention of cardiovascular disease, but could have adverse effects including advancing the “process of aging” and that “…long-term use of statins has been associated with adverse effects including myopathy, neurological side effects and an increased risk of diabetes.”
Is this going to make the new NICE guidelines more difficult to implement when patients shake their finger back at you at the mere suggestion they consider starting a statin?
Though the guidance states, and evidence is clear that there is benefit to be had for individuals with a QRISK2 of 10% or more, it’s worth looking at the NNT.
At 20% the NNT to prevent 1 cardiovascular event after 10 years of statin is 14. At 10% you need to treat 25 people for 10 years to prevent that 1 event.
It’s worth remembering that an estimated 80% of men over 50y and 55% of women over 60y have a 10y CVD risk over 10%.
So, if you’re in the mood to convince the patient with a QRISK2 of 10% in favour of statins, you may quote a 40% reduction in Cardiovascular Events over 10 years ( remember this is relative risk reduction). Or, if you can’t face a battle, you may agree with the patient and quote the NNT, so that of course your patient is making an informed decision.