Optimal risk thresholds for prescribing statins as primary prevention of cardiovascular disease in Iranian general population: a benefit-harm modelling study
BMC Cardiovascular Disorders, vol. 24, pp. 575
Abstract
PURPOSE: The use of statins for the primary prevention of cardiovascular diseases (CVD) is associated with various beneficial outcomes, alongside certain undesirable effects. This study aims to determine optimal risk thresholds above which statin therapy yields a net benefit, considering both the positive effects and potential adverse effects, as well as their probabilities and patient preferences. METHODS: Quantitative benefit-harm balance modeling was applied to the Iranian general population aged 40 to 75 years with no history of CVD. The analysis utilized data from prior studies, including statin effect estimates for different outcomes from a meta-analysis, patient preferences obtained from an Iranian survey, and baseline incidence rates of adverse outcomes sourced from the Global Burden of Disease study for Iran. Outcomes were defined as angina, myocardial infarction, fatal coronary heart disease, fatal or non-fatal stroke, and heart failure. Benefit-harm balance indices were calculated for various combinations of age, sex, and 10-year CVD risk. RESULTS: Statin therapy was found to be advantageous at a lower 10-year CVD risk threshold in men (18-23%) compared to women (24-28%). Furthermore, individuals aged 40-45 years exhibited a lower risk threshold (18% in men, 24% in women) than those aged 70-75 years (23% in men, 28% in women). CONCLUSION: The desirable 10-year risk thresholds for statin prescription in the primary prevention of CVD vary by age and gender, ranging from 18 to 28%, encompassing a spectrum of outcomes from angina to CVD mortality. These results suggest hard-CVD risk thresholds of 7.5% to 10% for both sexes.
Authors 7
-
Harvard University · Research Institute for Endocrine Sciences · Shahid Beheshti University of Medical Sciences
Affiliation as printed
Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Lown Scholar in Cardiovascular Health, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Hassan Saadati corresponding
North Khorasan University of Medical Sciences
Affiliation as printed
Department of Epidemiology and Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran. hasansaadati1391@gmail.com
-
Iran University of Medical Sciences · University of Aberdeen · Tehran University of Medical Sciences
Affiliation as printed
Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, Honorary Research Fellow, University of Aberdeen, Aberdeen, UK
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
-
Research Institute for Endocrine Sciences · Shahid Beheshti University of Medical Sciences
Affiliation as printed
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Leiden University Medical Center · Erasmus MC
Affiliation as printed
Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
-
The George Institute for Global Health · UNSW Sydney · The George Institute for Global Health · Imperial College London
Affiliation as printed
The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
The George Institute for Global Health, University of New South Wales, Sydney, Australia
-
Affiliation as printed
Department of Global Health and Population and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Cited by 2 stored of 2
2 results
No patents citing this paper on Lens.org (checked 2026-10-11).