Giving patients statins for primary prevention may mean patients live longer – but only for a matter of weeks, according to a new analysis described in a hotly debated session at Pulse Live. Macclesfield GP Dr Malcolm Kendrick said data shows that after five years of secondary prevention treatment with a statin, the average person just lives fourteen days longer as a result. But Whitby GP and Cardiology GPSI Dr Terry McCormack countered that the latest, most robust evidence shows the benefits of statin treatment in primary prevention outweigh the risks even among people with the lowest baseline risk.
The debate ended in a draw between the loyalists and the sceptics, with Dr Kendricks appearing to win a few GPs to his side. Speaking first in the debate, Dr Kendrick - a long-standing critic of established cholesterol-lowering practice and author of The Great Cholesterol Con – described the provocative findings from his as-yet unpublished analysis of the secondary prevention trial the Heart Protection Study (HPS).
He told delegates that looking at the data differently, focusing on life expectancy instead of mortality reductions, reveals that even the 1.8% of patients who derive benefit from statin treatment live only four months longer as a result of taking statins, while the remaining 98.2% do not gain anything. The average increase in life expectancy is 14 days.
He also argued that investigators and commentators have vastly overplayed results from primary prevention trials such as JUPITER, putting a spin on what are minimal absolute risk reductions in mortality while downplaying equivocal findings for other outcomes and the adverse events associated with statins.
‘We know that adverse event reporting is very, very low. Impotence, cognitive deficits, anger and irritation are all statin side effects that go unnoticed,’ Dr Kendrick said. The side effects are inevitable as a result of co-enzyme Q10 reductions, he added.
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