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GPs should consider offering statins to all patients aged over 75, researchers say

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l522 (Published 01 February 2019) Cite this as: BMJ 2019;364:l522

Re: GPs should consider offering statins to all patients aged over 75, researchers say

I would like ask Colin Baigent one question on this study - at this time. He claims that the Lancet study was a meta-analysis of twenty eight RCTs. The study was called. 'Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials.'

However, in the Appendix to the Lancet paper it is made clear that five of the studies are a comparison of high dose vs. low dose statins. PROVE-IT, A to Z, TNT, IDEAL and SEARCH. They cannot be used to test the hypothesis that statins are beneficial in the over 75s vs. placebo, as they were not done to answer this question.

Also, in nine of the RCTs used in the meta-analysis there were 0% participants over the age of 75 at the start of the study. These were 4S, WOSCOPS, CARE, Post CABG, AFCAPS/TexCaps, ALERT, LIPID, ASPEN and MEGA.

Which means that five of the studies could not address the question of statins vs placebo in the over 75s, and nine of the studies had no participants over the age of 75, which leaves fourteen studies that would be relevant to the issue of prescribing statins in the over 75s.

My question is, why did you call this study 'Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials.'

Competing interests: I have written two books on statins. The Great Cholesterol Con and A Statin Nation..

02 February 2019
Malcolm Kendrick
GP
Malcolm Kendrick
East Cheshire Hospital Trust
24 Prestwick Close