Intended for healthcare professionals

Rapid response to:


Statins for primary prevention of cardiovascular disease

BMJ 2019; 367 doi: (Published 16 October 2019) Cite this as: BMJ 2019;367:l5674

Rapid Response:

Paradox:Re: Statins for primary prevention of cardiovascular disease

There seems to be a sort of selective blindness with respect to the comparison of demographically similar groups in France and in Britain.
The figures cited below come from the British Heart Foundation and the BMJ as well as several individual commentaries
(UK & FRANCE MEN AGED 45 - 64)
Average total cholesterol level
France 6.1mmol/l
UK 6.2mmol/l
Average HDL ‘good cholesterol’
France 1.3mmol/l
UK 1.3mmol/l
Average systolic blood pressure
France 150mmHg
UK 148mmHg
Average body mass index (BMI)
France 26.6kg/m2
UK 26.6kg/m2
Rate of smoking
France 33%
UK 29%
Consumption of saturated fat % of calories
France 25.7%
UK 27.0%
Rate of type II diabetes (amalgamation of a number of studies)
France ~2.0%
UK ~2.0%
Death rate from CHD ICD 414 classification
France 128/100,000/year
UK 487/100,000/year
How does one explain the fact that two groups with near identical risk factors have such a disparity in CVD? Perhaps cholesterol, “good” or “bad” makes no difference except in familial hypercholesterolemia, the genetic condition for which statins were first created.
(Reference: .( Heart. 2004 Jan; 90(1): 107–111.
The French paradox: lessons for other countries
Jean Ferrières)

Competing interests: No competing interests

18 October 2019
Irene Campbell-Taylor
Clinical Neuroscientist
Private Practice
Mahone Bay, Nova Scotia