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August 15, 2012

Use of Statins in Healthy Men—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Division of Cardiology, University of California, San Francisco (Dr Redberg; redberg@medicine.ucsf.edu); and Department of Health Services, County of Los Angeles, Los Angeles, California (Dr Katz). Dr Redberg is the Editor and Dr Katz is the Deputy Editor of the Archives of Internal Medicine.

JAMA. 2012;308(7):666-667. doi:10.1001/jama.2012.8732

In Reply: The underlying premise of our Viewpoint was that the benefits of any prescribed medication should outweigh the risks for a given patient population. In the case of statins for healthy middle-aged men, that standard has not been met.

Dr Beckman suggests that Ray et al1 should have used a fixed-effects model instead of a random-effects model. However, given the different types of studies involved, it is more appropriate to assume that the true effect varies between studies and perform a random-effects model. Furthermore, even with the fixed-effect model, the result is not significant (ie, the upper confidence limit includes 1.00) or no benefit from statins.