Non-Atheroprotective Effects of Statins

Abstract

Since the introduction of HMG-CoA reductase inhibitors (statins) for lowering lipids, a large amount of data has been published demonstrating their potential benefits in conditions as varied as cancer, osteoporosis, and Alzheimer's dementia. We reviewed the published literature on MEDLINE from articles between 1950 and 2008 on the non-atheroprotective effects of statins and noted consistent benefits of statin use in improving outcomes of ventricular arrhythmias, sudden cardiac death, cardiac transplant rejection, chronic obstructive pulmonary disease, and sepsis. However, for these conditions, the level of evidence was inadequate to recommend statin use. The evidence for improving outcomes in atrial fibrillation, mortality in heart failure, contrast-induced nephropathy, cataract, age-related macular degeneration, sub-arachnoid hemorrhage, osteoporosis, dementia, and cancer incidence was conflicting and inconclusive. Furthermore, we found that most of the literature consists of small observational studies and their conclusions are often not corroborated by results from larger or randomized studies. Pending large, well designed, randomized trials, we conclude that there is no definite evidence for the use of statins in any condition besides hyperlipidemia and atherosclerosis.

Longitudinal Associations between Survival in Alzheimer's Disease and Cholinesterase Inhibitor Use, Progression, and Community-Based Services

“…In the present study, lipid-lowering agents and anxiolytics/sedatives/hypnotics were independent predictors of a longer lifespan. Besides the prevention of atherosclerosis, lipid-lowering agents have been shown to reduce mortality in several observational studies of, e.g., various types of heart failure, chronic obstructive pulmonary disease, and sepsis; however, the results are not conclusive [39]. Furthermore, sleep disturbances were independent predictors of cognitive deterioration, behavioral symptoms, falls, and shorter survival in older populations of nondemented and demented individuals.…”

Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population‐based perspective

“…While some observational studies have suggested that statin medications used to control cholesterol levels may reduce the risk of dementia [44,54,55], a Cochrane review and systematic reviews found no or inconsistent evidence that use of statins reduces risk [56][57][58]. The effect has not been seen to date in trials and highquality cohort studies.…”

Stroke and Dementia in Atrial Fibrillation

“…Sex difference of AD incidences between men and women may be attributed to better pharmacological treatment of men versus women. (Beri et al, 2009) …”