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Cohort study
Statin use associated with increased risk of cataract, myopathy, liver dysfunction and acute renal failure with varying numbers needed to harm
  1. Joanne Foody
  1. Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Joanne Foody
    Cardiovascular Medicine, Faulkner Hospital, 1153 Centre Street, Jamaica Plain, MA 02130, USA; jfoody{at}partners.org

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Context

Cardiovascular disease is the leading cause of premature death and a major cause of disability in most industrialised nations. Multiple studies and international guidelines support the use of statins to reduce the risk of cardiovascular disease. As such, statins are among the most widely prescribed medications. However, the intended as well as unintended consequences of their widespread use are unknown in large representative populations. Therefore, investigators performed a large population-based study to examine a range of clinical outcomes that have been found to be positively or negatively associated with statin use, including myopathy and rhabdomyolysis, Parkinson's disease, dementia, liver dysfunction, venous thromboembolism, rheumatoid arthritis, cataract, common cancers, osteoporotic fracture as well as acute renal failure.

Methods

This is a large prospective cohort study of primary care patients in England and Wales aged 30–84 years from January 2002 through June 2008. To correspond to an intention to treat analysis, statin use was classified by type of statin first prescribed (atorvastatin, simvastatin, fluvastatin, pravastatin or rosuvastatin). In total, 2 004 692 patients aged 30–84 years of whom 225 922 (10.7%) were new users of statins: 159 790 (70.7%) were prescribed simvastatin, 50 328 (22.3%) atorvastatin, 8103 (3.6%) pravastatin, 4497 (1.9%) rosuvastatin and 3204 (1.4%) fluvastatin.

Several outcomes were assessed using Read codes recorded in the patients' electronic records: acute renal failure; venous thromboembolism; Parkinson's disease, dementia; rheumatoid arthritis; cataract; osteoporotic fracture (spine, hip or wrist); …

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