A new study from Israel (Shalev, Chodick 2009) claims a 45% reduction in all-cause mortality with statin “even in primary prevention” – “the primary prevention cohort initially had no evidence of CHD or CVD” – thus like the JUPITER study postulating significant reduction also in non-CVD mortality..
But their table shows that at baseline in their “primary prevention” cohort, 58% had hypertension, 25% diabetes, a staggering 18% morbid obesity. . If these comorbidities – hypertension, diabetes, obesity- are not integral part and parcel of the spectrum of insulin resistance-metabolic-vascular (the lethal seeding of subintimal plaque) disease, then what are they?
Patients with such conditions can hardly be classified as “primary prevention” – and statins are notoriously known for doing nothing to reverse insulin resistance and weight gain, let alone diabetes and cancer- so they cannot influence the NON-CVD morbidity and mortality that affects the majority of us overweight elderly survivors from around WW2.
Paul Ridker conceded this in the Jupiter trial , admitting that probably a high percentage of deaths were indeed from CVD, not from non-CVD causes.
Only metformin does safely and effectively reduce non-CVD morbidity as much as it does CVD, and should have been used as baseline in all trialists – there are no absolute contraindications long term.
So far there is no evidence that statins significantly lower any non-CVD disease/ mortality.
Obviously in secondary prevention after major CVD events, the great majority of deaths will be from CVD- so statins can indeed modestly lower allcause mortality- but without any significant reduction in non-CVD mortality.