Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials


Smeeth, L; Douglas, I; Hall, AJ; Hubbard, R; Evans, S; (2009) Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials. British journal of clinical pharmacology, 67 (1). pp. 99-109. ISSN 0306-5251 DOI: 10.1111/j.1365-2125.2008.03308.x

Full text not available from this repository. (Request a copy)

Abstract

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT center dot The effect of statins on cardiovascular outcomes is well established. center dot Effects on numerous other health outcomes have been claimed, but results have been inconsistent. center dot Previous observational studies may have been affected by selection bias and confounding. WHAT THIS STUDY ADDS center dot This study was larger and more statistically powerful than the combined total of data from all randomized trials of statins undertaken to date. center dot The validity of the study is supported by findings for vascular outcomes being comparable to those observed in large randomized controlled trials. center dot There was little evidence to support effects of statins beyond their established effects on cardiovascular disease. To assess the effect of statins on a range of health outcomes. We undertook a population-based cohort study to assess the effect of statins on a range of health outcomes using a propensity score-based method to control for differences between people prescribed and not prescribed statins. We validated our design by comparing our results for vascular outcomes with the effects established in large randomized trials. The study was based on the United Kingdom Health Improvement Network database that includes the computerized medical records of over four and a half million patients. People who initiated treatment with a statin (n = 129 288) were compared with a matched sample of 600 241 people who did not initiate treatment, with a median follow-up period of 4.4 years. Statin use was not associated with an effect on a wide range of outcomes, including infections, fractures, venous thromboembolism, gastrointestinal haemorrhage, or on specific eye, neurological or autoimmune diseases. A protective effect against dementia was observed (hazard ratio 0.80, 99% confidence interval 0.68, 0.95). There was no effect on the risk of cancer even after >= 8 years of follow-up. The effect sizes for statins on vascular end-points and mortality were comparable to those observed in large randomized trials, suggesting bias and confounding had been well controlled for. We found little evidence to support wide-ranging effects of statins on health outcomes beyond their established beneficial effect on vascular disease.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Medical Statistics
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 19006546
Web of Science ID: 263303000013
URI: http://researchonline.lshtm.ac.uk/id/eprint/5543

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
310Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item