Long term Statin treatment
Practicing evidence based medicine means that you initiate statin treatment for the patients with cardiovascular diseases or TIA/Stroke if the level of the total cholesterol is >3.5 mmol/L. The clinical question arise all the time about the duration of the treatment with statin itself and if there is any side effect of this treatment. We might have the answer today from the trial that was published in The Lancet (The Lancet, 378; 9808:2013-2020).
Assessing the long- term efficacy and safety of Lowering LDL cholesterol, the authors of the Heart Protection Study (HPS) allocated 40 mg once a day simvastatin or placebo for 20 536 patients of vascular and non- vascular outcomes. Major vascular event was the primary outcome measure of the trial. A mean total duration of 11 years was yielded from the post-trial follow-up of surviving patients.
It was reported today that during the in-trial period, allocation to simvastatin yielded a proportional decrease in major vascular events of 23%. The trialists concluded that more prolonged LDL- lowering statin treatment produces larger absolute reductions in vascular events. The benefit of this treatment persists after stopping it for at least 5 years without any evidence of adverse reaction to the simvastatin.
The implications of such trials are significant on prevention strategies of stroke and cardiovascular diseases as hyperlipidemia is one of the established risk factors for cardiovascular diseases and stroke.