Resumen de The benefits and risks of statins for primary prevention of mortality and cardiovascular events: Umbrella review

Eva Martín-Ruiz, Antonio Olry de Labry Lima, David Mark Epstein

• Objectives: To describe the relative risks of statin treatment in primary prevention in cardiovascular events and adverse events based on an umbrella review of systematic reviews.

  Method: An umbrella review of statins versus placebo in primary prevention with outcomes of Relative Risk (RR) of mortality, non-fatal cardiovascular events and adverse events.

  Results: Six reviews met the inclusion criteria. Of these, one (the Cochrane review) was considered the most up to date and of the highest methodological quality. This estimated the RR of mortality for statins versus placebo as 0.86 [95% CI: 0.79-0.94] and for CVD events the RR was estimated as 0.65 [95% CI: 0.58-0.73].

  Statins were associated with a higher risk of diabetes and renal disorder.

  Discussion: Statins are highly effective in reducing CVD risk but there may be long term concerns about a possible elevated risk of diabetes and renal disorder. The risk of adverse events in primary prevention was identified in a single trial, the Jupiter study. However, this trial recruited more overweight and older participants, with elevated C-reactive protein, and not be fully generalizable to a general population considering primary prevention for CVD under current guidelines. Further investigation of the risk of these adverse events is warranted