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July 14, 2004

Risk-Treatment Paradox in Use of Statins

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;292(2):169. doi:10.1001/jama.292.2.169-a

To the Editor: Dr Ko and colleagues1 reported that the probability of receiving statin treatment actually decreases with increasing age and baseline risk for coronary heart disease. The authors defined baseline risk as the probability of death from any cause within 3 years. In high-risk older patients, death can be considered as a competing risk, and it has been recommended that limited life expectancy be factored into the creation of health care plans.2,3 Usually, death from cardiovascular disease is the most common form of an event that removes the risk of a different event. In this case, death from any cause can compete with the probability of benefit from statin therapy.