Effect of statins on a wide range of health outcomes: A cohort study validated by comparison with randomized trials

Liam Smeeth, Ian Douglas, Andrew J. Hall, Richard Hubbard, Stephen Evans

Research output: Journal PublicationArticlepeer-review

184 Citations (Scopus)

Abstract

AIMS: 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 ≥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.

Original languageEnglish
Pages (from-to)99-109
Number of pages11
JournalBritish Journal of Clinical Pharmacology
Volume67
Issue number1
DOIs
Publication statusPublished - Jan 2009
Externally publishedYes

Keywords

  • Clinical outcomes
  • Statins

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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