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Primary care
Absolute effects of statins in the elderly
  1. Carl Heneghan,
  2. Kamal R Mahtani
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Professor Carl Heneghan, Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK; carl.heneghan{at}phc.ox.ac.uk

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The effects of statins in the elderly are better informed by absolute effects and the number needed to evaluate the benefit to harm balance. Such an approach enables patients to make more informative choices.

Statins have proved to be a controversial topic. Thirty years after their approval, uncertainties remain about the benefit to harm balance in primary prevention of cardiovascular events, particularly in low-risk individuals and in the elderly. A recent meta-analysis of 28 trials including 14 483 (8%) participants older than 75 years aimed to reduce the uncertainties in statins in this older age group.1

After an average of 4.9 years of follow-up outcomes reported include major coronary events (non-fatal myocardial infarction or coronary death), coronary revascularisation (angioplasty or bypass grafting), stroke (subdivided by type), site-specific cancers and cause-specific mortality. Major vascular events were defined post hoc as a composite of major coronary events, coronary revascularisation and stroke.

The study concluded: ‘Statin therapy produces significant reductions in major vascular events irrespective of age, but there is less direct evidence of benefit among …

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