When it comes to evaluating the benefits of taking a statin to reduce the risk of heart attack and stroke, it’s essential to understand the difference between relative and absolute risk. These terms are often used in medical research and can significantly influence how the effectiveness of a treatment is perceived.
Once you understand the difference between relative and absolute risk, you will be better informed, and then you can contemplate the potential side effects as part of your overall consideration for taking a statin. What I have learned in working with thousands of people as clients, once all this is understood, practically all my clients choose to avoid statin use, and instead, take a lifestyle approach to reducing risk of heart attack and stroke.
Absolute Risk
Absolute risk refers to the actual likelihood of an event occurring in a specific population. For example, if 2 out of 100 people who do not take statins experience a heart attack within a year, their absolute risk is 2%. If taking a statin reduces this number to 1 out of 100 people, the absolute risk reduction is 1% (from 2% to 1%). This indicates that while statins do provide some protection against heart attacks, the actual chance of experiencing a heart attack is still relatively low.
Relative Risk
Relative risk reduction compares the difference in risk between two groups (those taking a statin vs. those not taking it) and expresses it as a percentage decrease. For instance, if the original risk of heart attack is 2% and taking a statin lowers it to 1%, that represents a 50% reduction in relative risk. This way of presenting data can make the impact of a treatment appear more dramatic.
The 36% Lipitor Claim: An Example of Relative Risk
A well-known example involves advertisements for the statin Lipitor (atorvastatin calcium), which claimed to reduce the risk of heart attack by 36%. While technically true, this figure is based on relative risk reduction over five years. The actual benefit, when considering absolute risk reduction, was much smaller. The absolute risk of a heart attack decreased by only 1.1 percentage points—from around 3% to 1.9%. This small improvement was inflated to a 36% relative risk reduction in marketing, making the treatment appear significantly more effective than the absolute numbers suggest.
Why It Matters
Understanding the difference between absolute and relative risk is crucial when evaluating medical treatments. Relative risk reductions often sound more impressive and can lead people to overestimate the benefits of a treatment. The actual chance of preventing an event like a heart attack may be modest. Absolute risk provides a clearer picture of what a treatment means for individual patients, helping them make informed decisions about whether the potential benefits outweigh the risks and side effects.
Conclusion
In the case of Lipitor, the relative risk reduction for heart attacks over five years was marketed as 36%, while the absolute reduction was just 1.1%. This demonstrates how relative risk figures can be used to present the benefits of a medication in a more favorable light. When considering a statin like Lipitor, it’s important to look beyond the marketing claims and understand both the relative and absolute risk reductions to make a well-informed choice.
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Robert Ferguson is a California- and Florida-based single father of two daughters, nutritionist, researcher, best-selling author, speaker, podcast and television host, health advisor, NAACP Image Award Nominee, creator of the Diet Free Life methodology, Chief Nutrition Officer for iCoura Health, and he serves on the Presidential Task Force on Obesity for the National Medical Association. You can e-mail Robert at robert@dietfreelife.com.
“Great article! Your explanation of absolute vs. relative risk in the context of statins is incredibly clear and informative. Excellent job breaking down concepts, making them accessible for patients. This article is a valuable resource for anyone looking to make informed decisions about their health. Thank you for sharing such insights and for your dedication to keeping people informed!”