Do statins really reduce risk of heart disease? By how much? Is absolute risk very low? How do absolute and relative risk compare? A general look at the science on statins and cardiovascular disease.
Statins: efficacy (do statins work), safety (potential side effects), funding concerns etc
emotional views: everybody should be on a statin, add statins to the water supply vs statins are poison
do statins lower cardiovascular risk?
clinical trials: half take a statin, half take a placebo. 22% lower risk of heart attacks, strokes etc. cardiovascular outcomes
The lower the LDL-cholesterol achieved… the lower the risk.
statins lower cholesterol and ApoB lipoproteins, that's why they lower risk. but trials look at LDL-cholesterol
clinical trials where cholesterol is lowered with statins: the longer the larger the benefit
statins help stabilize plaque and may reduce plaque volume but it´s a modest effect
Absolute risk is smaller, does that mean statins don’t work?
Absolute risk reduction heavily determined by the risk in the control group.
Relative risk reduction is more generalizable. Absolute risk reduction is more sensitive to the specific context. Absolute risk reduction tells us more about that specific experiment, Relative risk reduction gives us a general idea of what the drug can do.
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References:
https://academic.oup.com/eurheartj/article/38/32/2459/3745109#112366442
https://academic.oup.com/eurheartj/article/43/4/249/6342853
https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.121.008552
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.045851#d1e454
https://www.jacc.org/doi/pdf/10.1016/j.jacc.2018.06.046
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2790055
https://jamanetwork.com/journals/jama/article-abstract/199118
https://www.ahajournals.org/doi/full/10.1161/01.cir.0000140261.58966.a4
https://www.sciencedirect.com/science/article/abs/pii/S0021915009010053
https://jamanetwork.com/journals/jama/fullarticle/2556125
https://academic.oup.com/jnci/article/96/2/99/2520973
https://www.jacc.org/doi/10.1016/j.jacc.2020.07.059
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443441/
https://www.jacc.org/doi/pdf/10.1016/j.jacc.2018.06.046
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
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0:00 Introduction
0:19 My disclaimer
1:34 Do statins lower risk?
4:52 The effect of time
9:39 Putting it all together
11:01 Statins trials and industry funding
12:12 Absolute vs Relative Risk
18:46 Is it misleading to report relative risk?
20:51 The Bottomline