As a physician I always question the efficacy of drugs that I prescribe. One of the drugs that are prescribed to Americans on a daily basis are statin drugs to lower cholesterol Recently a metanalysis published in a peer review journal, JAMA Internal Medicine raised questions about the efficacy of statin for lowering cholesterol to reduce heart attacks strokes and all-cause mortality
The findings are important for both the doctor and the patient. The results were misleading The main finding was that the relative risk reductions in all cause mortality, heart attack and stroke were misleading compared to the absolute risk reduction.
The relative risk reduction ( RRR) were shown to be 9 % for all cause mortality, 29 % for heart attack and 14 % stroke. This sounds great for the use of statin for these . Then I viewed the results for the absolute risk reduction
The absolute risk reduction were 0.% for all cause mortality, 1.3 % for heart attacks and 0.4 % for stroke
The authors wrote this “Reporting the reduction in cardiovascular outcomes as RRR without reporting the absolute risk reduction ( ARR) has the potential to inflate the clinical importance of an intervention and can exaggerate trivial associations. “
So the question is —do I prescribe statins to reduce cholesterol ? Or do I reduce or change lifestyles as diet and exercise and use supplements and herbs to reduce cholesterol ?
Until tomorrow…