Association Between Statin Use and Cardiovascular Mortality at the Population Level: An Ecologic Study

Background: We assessed the contribution of statin use to the decline in cardiovascular mortality for The Netherlands over the period 1994-2010.

Methods: We combined aggregated mortality data from Statistics Netherlands with dispensing data from a representative drug dispensing database. We estimated mortality as if prevalence of statin use had remained at its observed 1994 levels throughout the period 1994-2010 for acute myocardial infarction, other ischemic heart disease, and cerebrovascular disease using Poisson models adjusted for various confounders.

Results: We estimated that keeping prevalence of statin use at observed 1994 levels would have resulted in 6.3 (95% confidence interval [CI] = 4.9, 7.8), 1.6 (95% CI = 0.8, 2.6), and 3.4 (95% CI = 2.2, 4.6) more acute myocardial infarction, ischemic heart disease, and cerebrovascular deaths per 10,000 person-years, respectively.

Conclusion: The findings indicate that statin therapy was associated with decreasing national cardiovascular mortality rates in the period 1994 to 2010.