USPSTF recommends statin use for adults at increased risk for cardiovascular disease

Adults between 40 and 75 years old who are at increased risk for cardiovascular disease may benefit from statins, according to a U.S. Preventive Services Task Force (USPSTF) systematic review.

The UPSPTF addressed the topic in a draft recommendation statement posted on Dec. 21. The public can review and comment from Dec. 22 to Jan. 25.

The researchers conducted an extensive literature review and identified 18 randomized trials that compared statin therapy with placebo or no statin and followed patients from six months to 5 years. The studies included adults without prior cardiovascular events.

The analysis found that patients who received statins had a 17 percent decreased risk of all-cause mortality, 36 percent decreased risk of cardiovascular mortality, 28 percent decreased risk of stroke, 37 percent decreased risk of MI and 31 percent decreased risk of composite cardiovascular outcomes. They added that they did not find that statin treatment in adults without prior cardiovascular events was associated with an increased risk of withdrawal due to adverse events, serious adverse events, cancer or elevated liver enzymes.

“Based on an analysis of individual patient data from randomized trials, greater reductions in low-density lipoprotein cholesterol levels with statin therapy are associated with reduced risk of [cardiovascular disease] events, providing some indirect evidence that higher intensity therapy may be associated with better clinical outcomes than lower intensity therapy,” the researchers wrote.

The Pacific Northwest Evidence-based Practice Center (EPC) conducted the review under contract to the Agency for Healthcare Research and Quality (AHRQ). However, the authors mentioned the views do not necessarily represent the views of the AHRQ and should not be construed as an official position of AHRQ or the U.S. Department of Health and Human Services.

The researchers mentioned that future research should focus on studies that compare titrated statin therapy to target lipid levels and fixed-dose therapy and higher versus lower intensity statin therapy. They added that more research was needed to determine if statin therapy was associated with an increased risk of diabetes or cognitive harms as well as to clarify the benefits and harms of statins in patients older than 80. In addition, they noted that they want to understand if statin therapy differs in racial and ethnic minorities.