Patients on a high-dose statin have a higher risk of developing diabetes compared to those on moderate doses, researchers from the University of Glasgow, Scotland, reported in the journal JAMA (Journal of the American Medical Association).
Statins reduce the incidence of cardiovascular events among patients with a history of diabetes as well as those without, when compared to a placebo.
As background information, the authors explain that recent studies have suggested there might be a higher risk of developing diabetes among those on intensive statin regimes.
The researchers wrote:
“Given the cardiovascular benefits of statins and the likely increasing use of intensive statin regimens, it is important to quantify any potential long-term risks to enable physicians and patients to make informed choices.”
David Preiss, M.R.C.P., and team carried out a meta-analysis of published and unpublished material from clinical trials – they wanted to determine whether there might be a link between intensive-dose statin therapy vs. moderate-dose therapy and diabetes and major cardiovascular events risk.
They eventually identified five randomized human studies involving 32,752 patients without diabetes that met their criteria for inclusion in the analysis. They were followed up for an average of 4.9 years.
8.4% (2,749) of them developed diabetes, of whom 1,449 had been on intensive-dose statin therapy and 1,300 on moderate-dose therapy. 20.4% (6,648) of them had a major cardiovascular event, of whom 3,134 had been on intensive-dose statin therapy and 3,550 moderate-dose therapy.
149 more patients on high-dose statins developed diabetes than those on the moderate dose. 416 more patients on moderate-dose therapy had a cardiovascular event compared to those on intensive-dose therapy.
The data, after being analyzed, indicated that intensive-dose therapy had two consequences compared to moderate-dose therapy, one good and one bad:
- Bad – it increased the risk of developing diabetes
- Good – it reduced the risk of experiencing a cardiovascular event
The authors concluded:
“Our findings suggest that clinicians should be vigilant for the development of diabetes in patients receiving intensive statin therapy. In conclusion, this meta-analysis extends earlier findings of an increased incidence of diabetes with statin therapy by providing evidence of a dose-dependent association.”
David Preiss, MRCP; Sreenivasa Rao Kondapally Seshasai, MD; Paul Welsh, PhD; Sabina A. Murphy, MPH; Jennifer E. Ho, MD; David D. Waters, MD; David A. DeMicco, DPharm; Philip Barter, MD, PhD; Christopher P. Cannon, MD; Marc S. Sabatine, MD, MPH; Eugene Braunwald, MD; John J. P. Kastelein, MD, PhD; James A. de Lemos, MD; Michael A. Blazing, MD; Terje R. Pedersen, MD, PhD; Matti J. Tikkanen, MD, PhD; Naveed Sattar, MD, PhD; Kausik K. Ray, MD
JAMA. 2011;305(24):2556-2564. doi: 10.1001/jama.2011.860
Written by Christian Nordqvist