Heart disease is the leading killer among men and women,
causing approximately 600,000 deaths each year, suggests the United States Centers for Disease Control and
World-renowned researchers from the Charles E. Schmidt College of
Medicine at Florida Atlantic University as well as Harvard Medical
School address the possible but unproven link between statins and
diabetes, as well as the implications of prescription of statins for
clinicians and their patients, in a commentary published in the
prestigious American Journal of Medicine
. The editor-in-chief of the journal published the commentary and an editorial he wrote online ahead of print.
‘The risk of diabetes, even if real, pales in comparison to the benefits of statins in both the treatment and primary prevention of heart attacks and strokes.’
Charles H. Hennekens, the first Sir Richard Doll
professor and senior academic advisor to the dean, the Charles E.
Schmidt College of Medicine at FAU; Bettina Teng, a recent pre-med
honors graduate of the Harriet L. Wilkes Honors College at FAU; and Marc
A. Pfeffer, the Dzau professor of medicine at HMS,
emphasize to clinicians that the risk of diabetes, even if real, pales
in comparison to the benefits of statins in both the treatment and
primary prevention of heart attacks and strokes.
"The totality of evidence clearly indicates that the more widespread
and appropriate utilization of statins, as adjuncts, not alternatives
to therapeutic lifestyle changes, will yield net benefits in the
treatment and primary prevention of heart attacks and strokes, including
among high, medium and low risk patients unwilling or unable to adopt
therapeutic lifestyle changes," said Hennekens.
In the accompanying editorial, Joseph S. Alpert, editor-in-chief and a renowned cardiologist and professor of medicine at
the University of Arizona School of Medicine, reinforces these
important and timely clinical and public health challenges in treatment
and primary prevention.
"There is no threshold for low density lipoprotein cholesterol below
which there are no net benefits of statins either in the treatment or
primary prevention of heart attacks and strokes," said Alpert.
The authors and editorialist express grave concerns that there will
be many needless premature deaths as well as preventable heart attacks
and strokes if patients who would clearly benefit from statins are not
prescribed the drug, refuse to take the drug, or stop using the drug
because of ill-advised adverse publicity about benefits and risks, which
may include misplaced concerns about the possible but unproven small
risk of diabetes.
"These public health issues are especially alarming in primary
prevention, particularly among women, for whom cardiovascular disease
also is the leading cause of death, and for whom there is even more
underutilization of statins than for men," said Hennekens.
At its national meeting in November 2013, the American Heart
Association, in collaboration with the American College of Cardiology,
presented and published its new guidelines for the use of statins in the
treatment and primary prevention of heart attacks and strokes, in which
the organizations also recommended wider utilization in both treatment