A point-by-point response to recent arguments against the use of statins in primary prevention.
Early in 2012, a debate over the merits of statin therapy in primary prevention was published in the Wall Street Journal. The statin opponent claimed that statins should only be used in secondary prevention and never in any primary-prevention patients at risk for cardiovascular events. In this evidence-based rebuttal to those claims, we review the evidence supporting the efficacy of statin therapy in primary prevention. Cardiovascular risk is a continuum in which those at an elevated risk of events stand to benefit from early initiation of therapy. Statins should not be reserved until after a patient suffers the catastrophic consequences of atherosclerosis. Contrary to the assertions of the statin opponent, this principle has been demonstrated through reductions in heart attacks, strokes, and mortality in numerous randomized controlled primary-prevention statin trials. In selected at-risk individuals, the combination of pharmacotherapy and lifestyle changes is more effective than either alone. Future investigation in prevention should focus on improving our ability to identify these at-risk individuals.
- Journal: Clinical Cardiology
- Year: 2012
- Topic: Cholesterol / Lipids / Statins, Cardiovascular Risk Assessment
- Read more articles by: Roger S. Blumenthal, MD, Michael Blaha, MD, MPH, Wendy S. Post, MD, MS, Seth Martin, MD, MHS, Steven Jones, MD