'The absolute benefits increased with continuing treatment, and treatment produced a clear reduction in all-cause mortality.'

Statins have been shown to reduce the incidence of coronary heart disease significantly in previous clinical trials, but uncertainties remained about their overall effect on mortality and major illness. Some studies had suggested that statins might increase the risk of certain types of cancer.

Reduction in All-Cause Mortality

Colin Baigent and colleagues from the Clinical Trial Service Unit (CTSU) at Oxford University, along with Anthony Keech and colleagues from the NHMRC Clinical Trials Center (CTC) in Sydney, combined data from 14 randomized trials of statins involving over 90,000 patients in the first meta-analysis of its kind.

Statin therapy reduced the 5-year incidence of major coronary events and stroke by about one fifth per mmol/L reduction in LDL cholesterol, the results show, irrespective of a person’s pre-treatment cholesterol level or other characteristics.

"The absolute benefits increased with continuing treatment," says Dr. Baigent, "and treatment produced a clear reduction in all-cause mortality. There was no evidence that lowering LDL cholesterol by 1 mmol/L with 5 years of statin therapy increased the risk of any specific cancer."

Major Clinical and Public Health Benefits

"Full compliance with available statin regimens can reduce LDL cholesterol by at least 1·5 mmol/L in many circumstances, and hence might be expected to reduce the incidence of major vascular events by about one third," notes Professor Keech.

"Ensuring that patients at high 5-year risk of any type of occlusive major vascular event achieve and maintain a substantial reduction in LDL cholesterol would result in major clinical and public-health benefits," he concludes.