Can statins extend life, and if so, by how much?

We’re often told that statin (cholesterol-reducing) drugs are effective for preventing heart disease and stroke (cardiovascular disease). Whether you buy into this statement or not depends, to a degree, on how you look at the data. It is true that statins reduce the risk of heart attack by about a third. However, this ‘relative risk’ reduction needs to be taken into the context of overall risk to begin with. For example, if the risk of succumbing to a heart attack is, say, 50 per cent over the next five years, then a third reduction in risk (about 17 per cent risk reduction) is perhaps meaningful. But if the underlying risk was, say, 3 per cent, then the overall risk reduction (what is known as the ‘absolute risk’ reduction) is a mere 1 per cent. As it turns out, many individuals on statins have low base risk and are therefore unlikely to see very significant benefits in terms of disease prevention as a result.

Another way to measure the impact of statins is to assess their effect on overall risk of death. Here, we can see if (over a finite period of time) those taking statins are statistically less likely to die than those not taking them. Now, it turns out that in individuals with no prior history of cardiovascular disease, statins do not reduce risk of death.

I was interested to read a study which was published recently in the journal PLoS Medicine which used statistical and mathematical models to calculate the likely increase in life expectancy from taking statins [1]. The predicted benefits appeared to depend on other characteristics such as weight, blood pressure and blood fat levels (those with unfavourable profiles were predicted to benefit more). Also, younger individuals were predicted to benefit more than older individuals.

Mathematical and statistical models are unlikely to accurately predict the true outcomes of a treatment, but they’re probably better than guessing. And it turns out that when all the individuals were thrown into the mix statins, on average, allowed individuals to live without cardiovascular disease for an additional 7 months. When it comes to the all-important life expectancy question, this was increased by an average of just 3 months. I did some maths and calculated that this represents an increase in lifespan of about 0.3 per cent.

Here’s some excerpts from what the journal’s editor had to say about this study:

Current guidelines recommend that asymptomatic (healthy) individuals whose likely CVD risk is high should be encouraged to take statins—cholesterol-lowering drugs—as a preventative measure. Statins help to prevent CVD in healthy people with a high predicted risk of CVD, but, like all medicines, they have some unwanted side effects, so it is important that physicians can communicate both the benefits and drawbacks of statins to their patients in a way that allows them to make an informed decision about taking these drugs. Telling a patient that statins will reduce his or her short-term risk of CVD is not always helpful—patients really need to know the potential lifetime benefits of statin therapy…

…The model estimated that statin therapy increases average life expectancy in the study population by 0.3 years and average CVD-free life expectancy by 0.7 years…

…These findings suggest that statin therapy can lead on average to small gains in total life expectancy and slightly larger gains in CVD-free life expectancy among healthy individuals,…

…Whether communication of personalized outcomes will ultimately result in better clinical outcomes remains to be seen, however, because patients may be less likely to choose statin therapy when provided with more information about its likely benefits.

These last words utterly sum up, I think, how it is in the real world: when individuals are informed about the true facts about the likely benefits, hardly without exception they take a pass. And that’s before we even get to talk about the potential side effects such as fatigue, muscle pain and memory loss.


1. Ferket BS, et al. Personalized prediction of lifetime benefits with statin therapy for asymptomatic individuals: a modeling study. PLoS Med. 2012 Dec;9(12):e1001361. doi: 10.1371/journal.pmed.1001361. Epub 2012 Dec 27.

9 Responses to Can statins extend life, and if so, by how much?

  1. Anne 13 February 2013 at 12:53 pm #

    It is a shame that no studies are done to show at what dosage statins have a positive effect. Statins have a pleitropic effect which occurs with very low doses, much lower doses than those needed for cholesterol lowering BUT what exactly are those doses ?

  2. Rita 15 February 2013 at 4:12 pm #

    “…The model estimated that statin therapy increases average life expectancy in the study population by 0.3 years and average CVD-free life expectancy by 0.7 years…”

    This gain is so small that it calls into question whether it has any statistical significance in the first place. 4-6 hypothetical extra months of life isn’t much of an incentive to take a drug with undesired effects like liver damage, memory loss and muscle weakness. Better to cut out the carbs and do some exercise…

  3. Stacie 15 February 2013 at 6:51 pm #

    In Dr. Kendrick’s book he does a similar calculation for middle-aged men with CAD. He calculates, according to statements made about The HPS that for every year of statin use, you gain a little under two days. So, if a man with CAD takes a statin for thirty years, he has extended his life by a little under two months. When you look at the numbers, it is astounding that these drugs are prescribed at all. Of course, all they are looking at are reductions in cholesterol, not meaningful endpoints.

  4. Barbara H. Roberts, MD, FACC 15 February 2013 at 9:07 pm #

    Very nice article with an easy to understand explanation of absolute versus relative risk.
    Barbara H. Roberts, MD, FACC

  5. Arun B Agarwal 16 February 2013 at 5:21 am #

    The statins bloc the production of cholesterol which is not all that bad as made out to be by certain interested parties without any research to back it.It is also sinister for people who believed in it without veryfying the facts.People were not dieing without statin drugs hunred years back.The causative factors of degenerative diseases should be found out and Government should stop towing the lines and interests of Pharmas,without this liberty and democracy has no meaning whatsoever.No form of governance has so much trust deficit as the present day democracy if you see the behaviour of pharmas and medical world by and large.Are doctors and their family have higher immune factors.If you bloc natural cholesterol,where from the coenzyme Q-10,other intermediaries will be manufactured including vitamin D.Are we planning to create a kingdom of Robots than vibrant living beings.A deep study about statins side effects is required.Let merceneries not guide medical field.

  6. Lorna 16 February 2013 at 9:52 am #

    ” Age, sex, smoking, blood pressure, hypertension, lipids, diabetes, glucose, body mass index, waist-to-hip ratio, and creatinine were included in the calculator.”
    The research clearly looked at a raft of ‘risk’ factors – why, therefore, does the average GP look at only one result i.e. total cholesterol before recommending statins? Why, also, does the average GP not look at lifestyle issues (clearly thought to be health issues in this research for heart disease)? It seems the advice given in many GP surgeries is at best incomplete.

  7. Judy Barnes Baker 18 February 2013 at 10:17 pm #

    What the studies don’t tell you is that ALL the patients given a stain drug are told to eat a low-fat, low-cholesterol diet. It is in the instructions that come with the prescriptions. I’d bet that all the tests done on statins were comparing groups of people who were all eating the same low-fat diet. The original study featured in the 1984 issue of Time Magazine that started the whole nonsense about cholesterol was a comparison of 2 groups, both eating the same low-fat/low-cholesterol diet. One got a statin drug; one did not. There was a slight reduction in heart attacks (but not mortality) in group that got the drug. What would the tests show if they compared a group taking statins to a group eating a low-carb/ high fat diet?

  8. Lorna 20 February 2013 at 10:55 pm #

    See the latest from American News below:
    Is there a glimmer of common sense peeping through the dollar signs at last?
    (Try to ignore the patronising style!!!)

  9. Alexander Cranford 23 February 2013 at 1:46 pm #

    Maybe there is some therapeutic value in statins because of the placebo effect.

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