BMJ Open雜志的一篇文章寫到府适，對于大于60歲的老年人，高的低密度膽固醇（high LDL cholesterol）和死亡率呈逆相關(guān)性纤掸。作者說到抬闯，他們很多人也懷疑這個結(jié)論的真實性，但是結(jié)論的一致性是令人驚訝的语婴。所以對于老年人他汀類藥物的益處被夸大了描孟。（這不是要砸很多人飯碗嘛）。當(dāng)然也有很多專家提出這個結(jié)論的問題砰左。
說到他汀類藥物匿醒，想起學(xué)術(shù)推廣中熟練運用數(shù)據(jù)的技巧，比如某藥做了個SPERCL研究（如有雷同純屬巧合）缠导，入組研究前1-6個內(nèi)患者腦卒中或TIA患者5000名廉羔，在隨訪的5年間，某他汀組265例患者發(fā)生死亡或非死亡腦卒中僻造，安慰劑組為311例憋他。DA上寫到腦卒中發(fā)生風(fēng)險比安慰劑組下降了15%?。數(shù)據(jù)很好髓削，最終銷量也很好竹挡。可仔細(xì)算算立膛，其中只有46位患者受益揪罕，占某他汀組（n=2500）的1.84%梯码，這數(shù)據(jù)還不如腫瘤藥呢。
https://m.firstwordpharma.com/study-suggests-benefits-statin-therapy-older-adults-may-be-exaggerated
原文如下：
Study suggests benefits of statin therapy in older adults may be "exaggerated"
Ref: The Guardian;The Times;Daily Mail;NHS Choices;The Telegraph;BMJ Open
Findings published in the BMJ Open journal from a systematic review of cohort studies indicate that high LDL cholesterol is "inversely associated with mortality" in most people aged 60?years and older. The authors, who remarked that their "analysis provides reason to question the validity of the cholesterol hypothesis," are calling for guidelines on the prevention of cardiovascular disease and atherosclerosis in older adults to be re-evaluated as they said "the benefits from statin treatment have been exaggerated."
Investigators conducted a search of the PubMed database and identified cohort studies in which LDL cholesterol had been investigated as a risk factor for all-cause and/or cardiovascular (CV) mortality in individuals from the general population aged 60 years or more. In all, 19 English-language studies met the criteria for review, and these included 30 cohorts involving a total of 68 094 participants. All-cause mortality was recorded in 28 cohorts and CV mortality in nine cohorts.
Researchers found that there was an inverse association between LDL cholesterol and all-cause mortality in 16 cohorts, representing 92 percent of the studied patients, with statistical significance observed in 14 cohorts, while no link was observed in the remaining 12 cohorts. In the studies assessing a CV mortality link specifically, there was no association seen in seven cohorts, while the other two found that those with LDL cholesterol levels in the lowest quartile had the highest CV mortality.
"What we found in our detailed systematic review was that older people with high LDL levels…lived longer and had less heart disease," remarked co-author Malcolm Kendrick, adding "many of us suspected this may be true but the consistency of the results was astonishing." Kendrick also predicted that the findings would likely stir controversy, but he defended them as "robust" and "thoroughly reviewed."
Still, some experts have pointed to limitations in the study, including the reliance on a single database, not looking at levels of other blood lipids, and the possibility that other health and lifestyle factors might be influencing the link. Further, the study authors acknowledged that their findings do not take into account the statin use by some participants during the observation period, which "may have increased the lifespan for the group with high LDL cholesterol."
Jeremy Pearson, associate medical director at the British Heart Foundation, said some of the study's results were not surprising "because, as we get older, many more factors determine our overall health, making the impact of high cholesterol levels less easy to detect." Nevertheless, he added that "the evidence from large clinical trials demonstrates very clearly that lowering LDL cholesterol reduces our risk of death overall and from heart attacks and strokes, regardless of age."
