title: Is statin-modified reduction in lipids the most important preventive therapy for cardiovascular disease? A pro/con debate.
abstract: The most prescribed medications in the world are statins, lipid modifiers that have been available for over 25 years and amongst the most investigated of all drug classes. With over a million patient years of trial data and publications in the most prestigious medical journals, it is remarkable that quite so much debate remains as to their place in healthcare. They have had a bittersweet passage, with vocal concerns over their possible risks, from suicide to cancer, and allegations that they do not work in women or the elderly, to statements that the whole published dataset, on over 200,000 patients consenting to enter trials, was fatally compromised by being industry-funded by and large. On the other side, there have been billions of dollars spent on generating their evidence base followed by promotion which has returned that investment many times over in profits, and a powerful scientific lobby that argue they are wonder drugs and that continued nihilism on their value risks patient lives. So who is right?
authors.affiliation: Nuffield Department of Primary Care Health Sciences, Oxford, UK. richard.hobbs@phc.ox.ac.uk.
authors.forename: F D Richard
authors.initials: FD
authors.lastname: Hobbs
authors.affiliation: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland. maciejbanach@aol.co.uk.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
authors.affiliation: Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London, London, UK. mikhailidis@aol.com.
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.affiliation: Frimley Park Hospital, Surrey, UK. aseem_malhotra@hotmail.com.
authors.forename: Aseem
authors.initials: A
authors.lastname: Malhotra
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK. capewell@liverpool.ac.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D015536:Down-Regulation / Q000187:drug effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects*; D008055:Lipids / Q000097:blood; D008297:Male; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids