Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis.
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TLDR
Statins can lower LDL cholesterol concentration by an average of 1.8 mmol/l which reduces the risk of IHD events by about 60% and stroke by 17% and is corroborated by results from the nine cohort studies.Abstract:
Objectives To determine by how much statins reduce serum concentrations of low density lipoprotein (LDL) cholesterol and incidence of ischaemic heart disease (IHD) events and stroke, according to drug, dose, and duration of treatment. Design Three meta-analyses: 164 short term randomised placebo controlled trials of six statins and LDL cholesterol reduction; 58 randomised trials of cholesterol lowering by any means and IHD events; and nine cohort studies and the same 58 trials on stoke. Main outcome measures Reductions in LDL cholesterol according to statin and dose; reduction in IHD events and stroke for a specified reduction in LDL cholesterol. Results Reductions in LDL cholesterol (in the 164 trials) were 2.8 mmol/l (60%) with rosuvastatin 80 mg/day, 2.6 mmol/l (55%) with atorvastatin 80 mg/day, 1.8 mmol/l (40%) with atorvastatin 10 mg/day, lovastatin 40 mg/day, simvastatin 40 mg/day, or rosuvastatin 5 mg/day, all from pretreatment concentrations of 4.8 mmol/l. Pravastatin and fluvastatin achieved smaller reductions. In the 58 trials, for an LDL cholesterol reduction of 1.0 mmol/l the risk of IHD events was reduced by 11% in the first year of treatment, 24% in the second year, 33% in years three to five, and by 36% thereafter (P Conclusions Statins can lower LDL cholesterol concentration by an average of 1.8 mmol/l which reduces the risk of IHD events by about 60% and stroke by 17%.read more
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Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis
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Effect of statins on risk of coronary disease: a meta-analysis of randomized controlled trials.
TL;DR: The meta-analysis indicates that reduction in LDL-C associated with statin drug treatment decreases the risk of coronary heart disease and all-cause mortality.
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By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease
TL;DR: The results from the cohort studies, international comparisons, and clinical trials are remarkably consistent and estimate that a long term reduction in serum cholesterol concentration of 0.6 mmol/l (10%), which can be achieved by moderate dietary change,owers the risk of ischaemic heart disease by 50%" at age 40, falling to 20% at age 70.
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Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials
TL;DR: Combination low dose drug treatment increases efficacy and reduces adverse effects and three drugs at half standard dose are estimated to lower blood pressure and thereby reduce the risk of stroke by 63% and ischaemic heart disease events by 46% at age 60-69.
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