Hi Jeremy – I agree with James that we shouldn’t use the term high risk. James also makes the important point about there being no 10-year trials of statins. That's one of the main reasons why we estimate 5-year risk rather than 10-year risk in New Zealand.
I would also suggest you look at the meta-analysis of statin trials from Rory Collins where he stratifies the benefits per 1mmol/L reduction in LDL by 5-year baseline risk. Lancet. 2012 Aug 11;380(9841):581-90.
Hi Jeremy - "high risk" - a term we should never use because it means different things to different people is typically considered to be a >20% absolute risk of CVD over 10 years but I’ve seen many different thresholds - another reason yet again to not use
the term.
To get the absolute benefit I just assume statins reduce CVD relatively by 25-35% depending on what doses are used and apply that number to the baseline risk.
With all the caveats - there are no 10 year studies, risk calculators typically overestimate risk etc.
Hope that helps.
James
Does anyone have any information about the ABSOLUTE RISK REDUCTION of statins for high risk individuals?
I realise that ‘high risk’ is classified a number of ways, as long as it is specified I don’t might which classification is used.
Thanks in advance!
Jeremy
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Nuffield Department of Primary Care Health Sciences, University of Oxford
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