Even people with very low risk of heart disease get just as much protection from statins as people at high risk — the lower your risk, the more you benefit per unit of cholesterol lowered.
Scientific Claim
The proportional benefit of statin therapy on major vascular events is at least as large in individuals with a 5-year vascular risk below 10% as in those with higher risk, challenging the assumption that benefit is proportional to baseline risk.
Original Statement
“The proportional reduction in major vascular events was at least as big in the two lowest risk categories as in the higher risk categories (RR per 1.0 mmol/L LDL cholesterol reduction from lowest to highest risk: 0.62, 0.69, 0.79, 0.81, and 0.79; trend p=0.04).”
Evidence Quality Assessment
Claim Status
appropriately stated
Study Design Support
Design supports claim
Appropriate Language Strength
definitive
Can make definitive causal claims
Assessment Explanation
The trend analysis across risk groups is based on individual participant data from RCTs, allowing direct comparison of proportional effects. The p-value confirms statistical significance.
Evidence from Studies
Supporting (1)
The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials
Even people with a very low chance of having a heart attack or stroke still benefit just as much—maybe even more—from statins as those at higher risk, which means doctors should consider giving statins to more low-risk people than previously thought.