AIM: Ongoing statin therapy associated with lower risk of death
Patients with high cholesterol levels who continually take statins appear to have a lower risk of death, regardless of whether they already have diagnosed heart disease, according to a report of a 4.5-year follow-up in the Feb. 9 issue of Archives of Internal Medicine.
Varda Shalev, MD, and colleagues at Maccabi Healthcare Services and Sackler Faculty of Medicine in Tel Aviv, Israel, analyzed data from 229,918 adults (average age 57.6) enrolled in a health maintenance organization who began taking statins between 1998 and 2006.
This included 136,052 individuals without heart disease (primary prevention group), who were followed for an average of four years, and 93,866 already diagnosed with heart disease (secondary prevention group), with an average five years of follow-up. The researchers checked pharmacy records to calculate the proportion of days that each individual took statins.
During the study, 4,259 patients in the primary prevention group and 8,906 in the secondary prevention group died. In both groups, the investigators said that the continuity of taking statins--defined as taking statins for at least 90 percent of the follow-up period--conferred at least a 45 percent reduction in the risk of death compared with patients who took statins less than 10 percent of the time.
The risk reduction was stronger among patients with high levels of LDL cholesterol at the beginning of the study and among patients whose initial treatment was with high-efficacy statins.
"In conclusion, this study showed that the continuation of statin treatment provided an ongoing reduction in all-cause mortality for up to 9.5 years among patients with and without a history of coronary heart disease," the authors wrote. "The observed benefits from statins were greater than expected from randomized clinical trials, emphasizing the importance of promoting statin therapy and increasing its continuation over time for both primary and secondary prevention."
Varda Shalev, MD, and colleagues at Maccabi Healthcare Services and Sackler Faculty of Medicine in Tel Aviv, Israel, analyzed data from 229,918 adults (average age 57.6) enrolled in a health maintenance organization who began taking statins between 1998 and 2006.
This included 136,052 individuals without heart disease (primary prevention group), who were followed for an average of four years, and 93,866 already diagnosed with heart disease (secondary prevention group), with an average five years of follow-up. The researchers checked pharmacy records to calculate the proportion of days that each individual took statins.
During the study, 4,259 patients in the primary prevention group and 8,906 in the secondary prevention group died. In both groups, the investigators said that the continuity of taking statins--defined as taking statins for at least 90 percent of the follow-up period--conferred at least a 45 percent reduction in the risk of death compared with patients who took statins less than 10 percent of the time.
The risk reduction was stronger among patients with high levels of LDL cholesterol at the beginning of the study and among patients whose initial treatment was with high-efficacy statins.
"In conclusion, this study showed that the continuation of statin treatment provided an ongoing reduction in all-cause mortality for up to 9.5 years among patients with and without a history of coronary heart disease," the authors wrote. "The observed benefits from statins were greater than expected from randomized clinical trials, emphasizing the importance of promoting statin therapy and increasing its continuation over time for both primary and secondary prevention."