Letters Statins for everyone?

Authors’ reply to Davis and Dietrich

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1792 (Published 26 February 2014) Cite this as: BMJ 2014;348:g1792
  1. John D Abramson, lecturer1,
  2. Harriet G Rosenberg, professor emeritus2,
  3. Nicholas Jewell, professor3,
  4. James M Wright, co-managing director and chair4
  1. 1Department of Health Care Policy, Harvard Medical School, Ipswich, MA 01938, USA
  2. 2Department of Social Science, York University, Toronto, ON, Canada
  3. 3Division of Biostatistics, School of Public Health Department of Statistics, University of California, Berkeley, CA, USA
  4. 4Therapeutics Initiative, Departments of Anesthesiology, Pharmacology and Therapeutics and Medicine, University of British Columbia, Vancouver, BC, Canada
  1. john_abramson{at}med.harvard.edu

Davis and Dietrich raise important concerns about our analysis of the effect of statins in people at low risk of cardiovascular disease.1 2

On the basis of Cholesterol Treatment Trialists’ (CTT) data published in 2012,3 we showed that statins do not reduce overall mortality in people with less than a 20% 10 year risk of a major vascular event. Davis and Dietrich are correct that all cause mortality was significantly reduced in patients treated with rosuvastatin compared with controls in the JUPITER trial.4 However, the data from this study were included in the CTT meta-analysis of 2012, so singling out the all cause mortality findings from this study alone would undermine the purpose of the meta-analysis.

That said, other aspects of the JUPITER trial merit consideration. At the time that the study was prematurely stopped, the number of deaths from cardiovascular causes (myocardial infarction and …

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