The controversy of a wider statin utilization: Why?

Ishak Mansi, Eric Mortensen

Research output: Contribution to journalReview articlepeer-review

31 Scopus citations


Introduction: Several medical journals published viewpoints and counter-viewpoints supporting or opposing a wider utilization of statins for primary prevention. The objective of this article is not to weigh in the benefits versus risks of statin use, but to discuss various aspects of this controversy. Areas covered: This review discusses the challenges in examining the pleotropic effects/adverse events of statins. It also discusses the pitfalls in assessment of adverse events in randomized controlled trials and observational studies. Expert opinion: The challenges in solving this controversy include that the pleotropic effect of statins results in an extremely wide spectrum of reported benefits or adverse events, the reported harms/benefits are contradictory, there is basic research ground supporting both sides of the controversy, it is difficult to separate if adverse events are due to statins or due to lower cholesterol, and that there is a lack of standardized definition of statin-associated adverse events and their methods of ascertainment. Both randomized controlled trials and observational studies have pitfalls and caveats in assessment of adverse events. Understanding the points of debate is of paramount significance to enable clinicians to individualize patient care.

Original languageEnglish (US)
Pages (from-to)327-337
Number of pages11
JournalExpert Opinion on Drug Safety
Issue number3
StatePublished - May 2013


  • Adverse events
  • Hyperlipidemia
  • Observational studies
  • Randomized controlled trials
  • Statin

ASJC Scopus subject areas

  • Pharmacology (medical)


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