Letters Neuromuscular degeneration

Doctors need to understand absolute versus relative risk reduction with statins

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e8357 (Published 10 December 2012) Cite this as: BMJ 2012;345:e8357
  1. Bernard Freudenthal, core medical trainee year 11
  1. 1Chase Farm Hospital, Enfield EN2 8JL, UK
  1. b.freudenthal{at}doctors.org.uk

In this Patient’s Journey, Mustafa Gunaydin presented to various doctors with marked subjective intolerance of statins before later developing myositis.1 It seems extraordinary that his doctors were so committed to continued statin treatment. The highest published absolute risk reduction in all cause mortality with statins in secondary prevention of ischaemic heart disease is 3.3% (4S trial2), so the number needed to treat is at least 30.3

It seems that many doctors are either not aware of the actual benefits of the drugs that they prescribe or do not understand the basic statistical implications of absolute versus relative risk reduction.

Although a population of patients will benefit from full pharmacological secondary prevention in ischaemic heart disease, individual patients should be free to opt out. This patient may have been wise to do so, if a properly informed doctor had counselled him about the actual degree of risk involved.


Cite this as: BMJ 2012;345:e8357


  • Competing interests: None declared.


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