The cardiovascular benefits of taking statins outweigh the risk of diabetes, even in high risk individuals, according to a study published on Aug. 9 in The Lancet.

The study, the first placebo-controlled statin trial to formally report an increased risk of developing diabetes, found "in individuals with one or more risk factors, statin allocation was associated with a 39 percent reduction in the primary endpoint, a 36 percent reduction in venous thromboembolism, a 17 percent reduction in total mortality, and a 28 percent increase in diabetes." Whereas in individuals with "no major diabetes risk factors, statin allocation was associated with a 52 percent reduction in the primary endpoint, a 53 percent reduction in venous thromboembolism, a 22 percent reduction in total mortality, and no increase in diabetes."

By comparison with placebo, statins accelerated the average time to diagnosis of diabetes by 5•4 weeks (84•3 [SC 47•8] weeks on rosuvastatin vs. 89•7 [50•4] weeks on placebo, the authors add. 

 

The trial, called JUPITER, was a randomized, double-blind trial that looked at 17,603 men and women without previous cardiovascular disease or diabetes over five years. As previous studies have suggested that statins increase risk of development of diabetes, which have led to recent regulatory changes, the authors aimed to "address the balance of vascular benefits and diabetes hazard of statin use."

 

In an editorial comment, Gerald F. Watts and Esther M. Ooi from the Cardiometabolic Research Centre and Clinical Services at the Royal Perth Hospital in Perth, Australia, note, "these findings reaffirm the net value of statins in the primary prevention of cardiovascular disease, but intuitively caution that the diabetogenic effect of these drugs is highest in individuals with risk factors for diabetes, including raised C-reactive protein."

POSTED BY:  Steven Almany M.D.