SynthesisBMC medicine2014
Unintended effects of statins from observational studies in the general population: systematic review and meta-analysis.
Synthesis in BMC medicine, 2014. The graph read 4 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It also reports an association that does not count as treatment evidence, such as OR 0.74 (0.62 to 0.87) for quality of life & behaviour. It is linked to 2 registered trials, which are not on this map. Cited by 77 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
Read, but not usablea number the graph found but could not read as for or against
Statins were associated with lower risks of dementia and cognitive impairment, venous thrombo-embolism, fractures and pneumonia, but these findings were attenuated in analyses restricted to higher quality studies (respectively: OR 0.74 (95% CI 0.62 to 0.87); OR 0.92 (95% CI 0.81 to 1.03); OR 0.97 (95% CI 0.88 to 1.05); OR 0.92 (95% CI 0.83 to 1.02)); and marked heterogeneity of effects across studies remained.
Statins were associated with lower risks of dementia and cognitive impairment, venous thrombo-embolism, fractures and pneumonia, but these findings were attenuated in analyses restricted to higher quality studies (respectively: OR 0.74 (95% CI 0.62 to 0.87); OR 0.92 (95% CI 0.81 to 1.03); OR 0.97 (95% CI 0.88 to 1.05); OR 0.92 (95% CI 0.83 to 1.02)); and marked heterogeneity of effects across studies remained.
Statins were associated with lower risks of dementia and cognitive impairment, venous thrombo-embolism, fractures and pneumonia, but these findings were attenuated in analyses restricted to higher quality studies (respectively: OR 0.74 (95% CI 0.62 to 0.87); OR 0.92 (95% CI 0.81 to 1.03); OR 0.97 (95% CI 0.88 to 1.05); OR 0.92 (95% CI 0.83 to 1.02)); and marked heterogeneity of effects across studies remained.
Statins were associated with lower risks of dementia and cognitive impairment, venous thrombo-embolism, fractures and pneumonia, but these findings were attenuated in analyses restricted to higher quality studies (respectively: OR 0.74 (95% CI 0.62 to 0.87); OR 0.92 (95% CI 0.81 to 1.03); OR 0.97 (95% CI 0.88 to 1.05); OR 0.92 (95% CI 0.83 to 1.02)); and marked heterogeneity of effects across studies remained.
clause the extractor read what became the number
Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Statins×quality of life & behaviour
No readable resultOpen on the map →What to test next →3 readable studies in this cell: 0 favour the treatment, 2 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Electronic Polygenic Risk Study (PEPRS) - First Phase
Prospective Electronic Polygenic Risk Study - Second Phase
Who cites it
77 citing papers in PubMed, 8 syntheses or guidelines pooled it, 183 citations in OpenAlex.
- Assessment of adverse effects attributed to statin therapy in product labels: a meta-analysis of double-blind randomised controlled trials.Lancet (London, England) · 2026Pooled it
- Ezetimibe and the risk of new-onset type 2 diabetes: a systematic review and meta-analysis.Annals of medicine · 2025 · on this mapPooled it
- Associations between statins and adverse events in secondary prevention of cardiovascular disease: Pairwise, network, and dose-response meta-analyses of 47 randomized controlled trials.Frontiers in cardiovascular medicine · 2022Pooled it
- Associations between statins and adverse events in primary prevention of cardiovascular disease: systematic review with pairwise, network, and dose-response meta-analyses.BMJ (Clinical research ed.) · 2021 · on this mapPooled it
- Effect of statin use on the risk of rheumatoid arthritis: A systematic review and meta-analysis.Seminars in arthritis and rheumatism · 2020Pooled it
- Use of statins and the risk of dementia and mild cognitive impairment: A systematic review and meta-analysis.Scientific reports · 2018Pooled it
- Myopathy in older people receiving statin therapy: a systematic review and meta-analysis.British journal of clinical pharmacology · 2015Pooled it
- Do statins impair cognition? A systematic review and meta-analysis of randomized controlled trials.Journal of general internal medicine · 2015Pooled it
- The effect of statins on muscle symptoms in primary care: the StatinWISE series of 200 N-of-1 RCTs.Health technology assessment (Winchester, England) · 2021Trial
- Statin treatment and muscle symptoms: series of randomised, placebo controlled n-of-1 trials.BMJ (Clinical research ed.) · 2021Trial
- Effect of Switching from Low-Dose Simvastatin to High-Dose Atorvastatin on Glucose Homeostasis and Cognitive Function in Type 2 Diabetes.Vascular health and risk management · 2020Trial
- Therapeutic effects of atorvastatin and ezetimibe compared with double-dose atorvastatin in very elderly patients with acute coronary syndrome.Oncotarget · 2017Trial
- Trial
- Association between beta-blocker and statin use and mental health in patients following pulmonary embolism: a prospective cohort study.BMC psychology · 2026Observational
- Statin therapy and neuropathy in type 1 diabetes: A cross-sectional study.Diabetes, obesity & metabolism · 2025Article
- HMG-CoA reductase inhibitors (statins) versus placebo for people with schizophrenia.The Cochrane database of systematic reviews · 2025Article
- Novel Insights into the Mechanism and Treatment of Diabetes-Related Brain Complications: Focusing on the Blood-Brain Barrier Impairment.Aging and disease · 2025Review
- Statin use and the risk of tubulointerstitial nephritis: a real-world signal detection analysis using FDA Adverse Event Reporting System.Frontiers in medicine · 2025Article
- The Polypill: A New Alternative in the Prevention and Treatment of Cardiovascular Disease.Journal of clinical medicine · 2024Review
- Age and sex specific thresholds for risk stratification of cardiovascular disease and clinical decision making: prospective open cohort study.BMJ medicine · 2024Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
The marked sentences are the ones the graph read a number from.
backgroundEfficacy of statins has been extensively studied, with much less information reported on their unintended effects. Evidence from randomized controlled trials (RCTs) on unintended effects is often insufficient to support hypotheses generated from observational studies. We aimed to systematically assess unintended effects of statins from observational studies in general populations with comparison of the findings where possible with those derived from randomized trials.
methodsMedline (1998 to January 2012, week 3) and Embase (1998 to 2012, week 6) were searched using the standard BMJ Cohort studies filter. The search was supplemented with reference lists of all identified studies and contact with experts in the field. We included prospective studies with a sample size larger than 1,000 participants, case control (of any size) and routine health service linkage studies of over at least one year duration. Studies in subgroups of patients or follow-up of patient case series were excluded, as well as hospital-based cohort studies.
resultsNinety studies were identified, reporting on 48 different unintended effects. Statins were associated with lower risks of dementia and cognitive impairment, venous thrombo-embolism, fractures and pneumonia, but these findings were attenuated in analyses restricted to higher quality studies (respectively: OR 0.74 (95% CI 0.62 to 0.87); OR 0.92 (95% CI 0.81 to 1.03); OR 0.97 (95% CI 0.88 to 1.05); OR 0.92 (95% CI 0.83 to 1.02)); and marked heterogeneity of effects across studies remained. Statin use was not related to any increased risk of depression, common eye diseases, renal disorders or arthritis. There was evidence of an increased risk of myopathy, raised liver enzymes and diabetes (respectively: OR 2.63 (95% CI 1.50 to 4.61); OR 1.54 (95% CI 1.47 to 1.62); OR 1.31 (95% CI 0.99 to 1.73)).
conclusionsOur systematic review and meta-analyses indicate that high quality observational data can provide relevant evidence on unintended effects of statins to add to the evidence from RCTs. The absolute excess risk of the observed harmful unintended effects of statins is very small compared to the beneficial effects of statins on major cardiovascular events.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.