Effect of statins on a wide range of health outcomes: a cohort study validated by comparison with randomized trials.
OBJECTIVE
To assess the effect of statins on a range of health outcomes.


METHODS
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.


RESULTS
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 > or =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.


CONCLUSIONS
We found little evidence to support wide-ranging effects of statins on health outcomes beyond their established beneficial effect on vascular disease.
Smeeth
Liam
L
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. liam.smeeth@lshtm.ac.uk
Douglas
Ian
I
Hall
Andrew J
AJ
Hubbard
Richard
R
Evans
Stephen
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D020521:Stroke / Q000401:mortality; D006113:United Kingdom / Q000453:epidemiology; D014652:Vascular Diseases / Q000188:drug therapy* / Q000401:mortality
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors