However, the absolute risk reduction — the actual difference between the two groups, i.e., 3.1% minus 2% — is only 1.1%, which really isn’t very impressive. Given the proven benefits of statins in cardiovascular (CV) disease risk reduction, the use of more potent statins and statins at higher doses will result in greater CV risk reductions. Statins and CVD Risk Reduction. Always keep absolute risk in mind when you hear about the risk of an event increasing or decreasing. . et al. I am young scientist learning the ropes in my first lab tech position and look forward to learning more about how I can be a “good” scientist! Data from the ASCOTT-LLA trial representing the percent of … Choose a single article, issue, or full-access subscription. I’m talking about a specific, extra type of integrity that is not lying, but bending over backwards to show how you’re maybe wrong, that you ought to do when acting as a scientist. Padmanabhan S, Let's go back to our Entresto study. Comments are welcomed and encouraged. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. 7(October 1, 2010) : Why most biomedical research is flawed, and how to improve it, Teaching science through the lens of discovery, Time-restricted eating: efficacy versus effectiveness, Randomized controlled trials: when the gold standard leaves you with fool’s gold, http://ase.uva.nl/binaries/content/assets/subsites/amsterdam-school-of-economics/research/uva-econometrics/dp-2013/1303.pdf, https://www.york.ac.uk/depts/maths/histstat/smoking.htm, http://www.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults, movies depicting minor league hockey teams. The difference between relative risk and absolute risk. High-exposure statin users (HES) versus low-exposure statin users (LES) and annual risk for AD. It is self-persuasion that we must vigilantly guard against if we want to establish reliable knowledge about the world, and ourselves. Great blog on risk. Your odds go from 2-in-100 to 1.5-in-100. Statins are not particularly effective at reducing the risk of dying from heart disease, a study claims. In this case, smokers would be 100 times more likely to get lung cancer than never-smokers (i.e., 10,000% more likely), but the absolute risk difference is 0.5% (i.e., 0.5% – 0.005%). Criticism is far more useful than praise in science. This has helped me so much, I wish I had’ve read this while I was at school. Hi Peter, it’s UB from Baltimore. : results from 25 years of follow-up in the Renfrew and Paisley survey. The effectiveness of the flu shot is also expressed in relative risk. Comments that attack an individual directly will be deleted. to the editor: In this “Tips from Other Journals,” Dr. Crawford-Faucher reviewed the meta-analysis by Brugts and colleagues that concluded that statins are beneficial for primary prevention of cardiac disease.1 I agree with this conclusion, but with some reservations. “Nonusers are individuals without a hyperlipidemia diagnosis or individuals with undiagnosed hyperlipidemia or diagnosed hyperlipidemia who are not being treated or not adhering to medication.”, We’re intentionally belaboring the point that you should seriously question the validity of virtually any study and its implications. There is a big difference between relative and absolute risk reductions. Investigators try to decrease the potential for noise using various methods. All-cause mortality after a mean follow-up of 4.1 years was 5.1percent in the group treated with statins and 5.7 percent in the control group. Imagine if there were not ethical restraints on treating high risk cardiac patients with intensive statin, ezetimibe and niacin to get LDLp below 750 vs. control on diet allow? afpserv@aafp.org for copyright questions and/or permission requests. On the contrary, I think in many (most?) Understandably, with approximately 47.5 million individuals living with dementia worldwide, people are massively worried about the disease and are hopeful that a cure is in sight. “The research worker is sometimes a difficult person,” wrote W.I.B. .”. And, with this particular example, the absolute risk reduction is 0.63%. Repeat after me … each thing u think u see or think u know. There … : results from 25 years of follow-up in the Renfrew and Paisley survey. A re-reading of all the major statin studies shows nearly zero benefit of statins when correcting for absolute vs relative statistics. Include your complete address, e-mail address, and telephone number. Learn how and why people stop taking statins here. The collaborator points out the obvious, with due impatience. Copyright © 2020 American Academy of Family Physicians. The absolute risk is quite small, so the relative risk can … Copyright © 2010 by the American Academy of Family Physicians. True, absolute risk reduction is better than relative effectiveness (which seems used more to sound impressive than to impart reality) but the NNT is a much more meaningful number than either of them. While many or most readers may be ignorant of the issue, I don’t think the writers of the content fall into the same camp. I will remember this for the next paper I read. These trials are monumental in their contribution to science. What is the absolute effectiveness? Comments that harass other posters will be deleted. The former shows the percentage of the population that … . E-mail: tphillips@washingtonhospital.org. Decision making for the use of statins should consider individual baseline risk, absolute risk reduction and whether risk reduction justifies potential harms and taking a daily medicine for life. This is the chance of suffering from a heart attack or stroke in the next 10 years if you do not take the drug. Figure 6. It’s hard to get out of bed to read about a whopping 0.63% reduction in absolute risk when you could be reading about a—wait for it—85% relative risk reduction! It’s too damn hard to always think critically—and we are not wired to do it as humans—but we must always strive for it. The criticism of statin benefits in reducing CVD frequently uses a similar relative risk vs absolute risk discussion. Hoeks, It behooves us to understand the difference between relative risk and absolute risk—and to always report both to provide context. Risk for 100 people like you who do take statins on standard dose. So that there could be a real understanding and imparting of information on someone instead of just looking for eyeballs. Relative statistics sell product. Additionally, based on the study data, the NNT to prevent one major coronary event is 77, and the NNT to prevent one major cerebrovascular event is 250. . He’s just working shorter days. With the number set to triple by 2050, people are justifiably desperate for good news. This value indicates that 71 mostly primary prevention patients would have to be treated for 3 to 5 years to prevent one such event. In the case of statins, most people go on statins because … I am not a scientist but this is how i critically judge stuff. This is expanding my brain in understanding the discrepancies in the studies I have read. In December 2016, an exciting headline from the AAAS1The American Association for the Advancement of Science (AAAS), which publishes the very prestigious journals Science, Science Translational Medicine, Science Signaling, Science Advances, Science Immunology, and Science Robotics. Absolute risk reduction was 4.3% (NNT 23.2 over 3.2 years).1 U Subset analysis of one study reported the results of statin use (40mg simvastatin) vs placebo in 1263 CVD patients aged 75-80 years at study entry. After you’ve not fooled yourself, it’s easy not to fool other scientists. It’s difficult to put numbers and cost on even a single life saved, but it’s hard to argue the fact that a 10 percent relative risk reduction … Note that this study compared high-exposure vs. low-exposure statin users, but excluded non-users as a control group when calculating relative risk. Future Risk of having a heart attack. Say to your self … this is bullshit. Absolute risk reduction due to statin use according to sex. All rights reserved. 29 In the AFCAPS/TexCAPS trial, the absolute risk reduction for major cardiovascular events was 6.64 per 1000 person-years in persons with a 10-year risk … The number of strokes prevented per 1000 patients treated for 5 years in patients with CHD is 9 for statins, compared with 17.3 for antiplatelet agents. Over 10 years 20 people will have a heart atack 80 people will have no heart attack. Beveridge in The Art of Scientific Investigation (1957), “because he has no great confidence in his opinions, yet he also is [skeptical] of others’ views. This is a 50-fold difference that has a very real impact on both public, and individual, health. Perhaps just for teaching purposes.? The statistic may be more damaging in this respect. Share Facebook Diabetes Care. I am excited to be following you on your new website! . According to the study, more adherent statin users had about a 0.1% lower risk for AD compared with their less adherent counterparts, in absolute terms. Compared to placebo, the absolute risk reduction with atorvastatin was similar in patients with LDL cholesterol concentrations > 120 or < 120 mg/dl (reduction from 9.5 to 6.1% vs. reduction from 8.5 to … 9 out of 100 people get the flu with the shot vs 10 out of 100 without the shot. Kostis WJ. We’re extremely messy creatures. However these concepts are critical for communicating information to your patients. What are the harms of statins and what is the number needed to harm? Note that this is a relative risk, so the absolute risk of developing diabetes while taking a statin is very low. 2012 Feb 7;59(6):583-4. This comment policy is subject to change at any time. HES indicates high-exposure users. It’s all too human to look at the problem and think that we have to act now, we have to do something, we don’t have time to hem and haw. This article really helped to generate some more ideas! Get Permissions, Access the latest issue of American Family Physician. Relative risk reduction resulted in a 21% higher probability of choosing to take statins over all values of RIS compared to the absolute summary statistics. At Year 5 since randomization, 1430 patients remained in the VASCEPA arm vs 1358 patients in the placebo arm. Because absolute risk is usually pretty low in drug studies, the pharmaceutical industry typically uses the relative risk number to sell their medicines. This corresponds to a number needed to treat (NNT) of 5; i.e., for every five participants shown the relative risk reduction one additional participant chose to take statins, compared to the other summary statistics. This is 1 of the highest NNT to prevent 1 major cardiovascular event in a randomized statin … In the pooled data the statins reduced the cardiovascular measures, total myocardial infarction and total stroke, by 1.4% as compared to control. So you have to be very careful about that. Neither are you “wrecking” your heart. Sounds pretty good, right? To the Editor: In her Perspective article, Goldfine (May 10 issue)1 correctly states that the benefits of statins outweigh the risks in patients with known cardiovascular disease. Whiteley L, 1. (statins) in the context of reducing the risk of vascular events in older people. Brugts JJ, Comments requesting medical advice will not be responded to, as I am not legally permitted to practice medicine over the internet. Imagine an intervention that lowers relative risk by 85% (Figure 2). In this video I review the data on perioperative use of statins and their effects on perioperative cardiac events A good scientist values criticism almost higher than friendship: no, in science criticism is the height and measure of friendship. Bummer. Nice refresher on the statistics issue but I have a quibble that the use of statistics is an “unwitting chicanery” by scientists or journalists. ... We hope that the concept will continue to prove useful in explaining risks and benefits in absolute terms (i.e. , Well stated. BMJ. As we set off on our inaugural Nerd Safari, we think a primer on interpreting research—“studying studies,” so to speak—might be helpful. Relative and absolute risk, observational studies and clinical trials, power analysis and statistical significance, the myriad biases and threats to internal validity are some of the larger themes throughout the series. The way most studies interpret and report the results is through relative risk reduction (or increase). Absolute Risk Reduction. Let’s now go back to our more practical example: the observations of statin use and the incidence of AD (Figure 4). From these results, let’s see how absolute and relative risk are calculated (Figure 3). Should diabetes be considered a coronary heart disease risk equivalent? NS indicates non-statin users (i.e., non-users). Professor Spiegelhalter has found out that people like him (age, blood pressure, lifestyle factors) have a baseline absolute risk … But science is all about the hem and the haw: the hesitation, the indecisiveness (science is never necessarily settled). Then seek to prove not yourself right but the other right. Although statins provide a significant reduction in mortality in high-risk groups, this benefit has not been shown in lower-risk groups. More adherent statin users had about a 0.1% lower risk for AD compared with their less adherent counterparts (1.6% – 1.5%), in absolute terms. Twain is determining his writing output and comparing it to when he was younger. • The event rate is the proportion of people in the population who … The results of statin trials have demonstrated remarkable uniformity with regard to their benefit in reducing the risk of CHD. Thank you….this was very helpful. Following up on myself – and for anyone who might be interested in my question above. It would be interesting to see if a patient's decision whether or not to take the drug was influenced by using one of the following statements: “This drug will decrease your chance of dying by 12 percent.”; or “Out of the 167 patients that take this pill for the next four years, one patient will not die who would have if he or she had not taken the drug, but 166 will take the medicine and get no benefit, and may be harmed.”. We only accept comment from posters who identify themselves. “Individuals categorized as having high-exposure fell into at least the 50th percentile of days of filled prescriptions in a given year for at least 2 years during 2006, 2007, and 2008,” according to the study. It is this simple. For example, in the JUPITER trial, the NNT to prevent 1 cardiovascular event was 94 in people younger than 70 years and 62 in those 70 years and older. Hence, the 10% effectiveness rate for the 2017/2018 flu season is actually much worse than most people think. , … The article reports on an observational study2“In fields such as epidemiology, social sciences, psychology and statistics,” Wikipedia notes, “an observational study draws inferences from a sample to a population where the independent variable is not under the control of the researcher because of ethical concerns or logistical constraints.” of 399,979 statin users published in JAMA Neurology. The event rate reflects the percentage of events that occurred in each group. For every five participants shown the relative risk reduction statistic, an extra participant chose to take statins compared to the other summary statistics. That said, observational data from the Women’s Health Initiative found a 48 percent increased risk of diabetes in healthy women taking statins after adjusting for other risk … Events indicates cases of AD. For high-exposure users, a 1.5% incidence. Looking at the Benefit of Statins from a Different Perspective. However, the addition of ezetimibe over statins produced a 12% and 13% risk reduction in patients with baseline eGFR <60 ml/min and <45 ml/min, respectively. Reportedly, among women who were high users of statins, the incidence of AD was 15% lower. Importantly, despite the small reductions in nonfatal heart attacks and strokes, statins were not associated with a reduction in serious illness overall (relative risk = 0.99; 95% confidence interval, 0.94 to 1.04).4 Adverse events from statin use include myalgia and new-onset diabetes at a rate of 4.8% (number needed to harm [NNH] = 21) and 0.49% over five years (NNH = 204), … That takes on a different urgency than the quoted 50% relative risk … Isles C. That is an absolute risk reduction of 4% . Imagine if the risk of getting lung cancer for a never-smoker was 0.005%, or 1-in-20,000, and the risk for a smoker was 0.5%, or 1-in-200. This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online. The purpose of comments on our site is to expand knowledge, engage in thoughtful discussion, and learn more from readers. 82/No. People in the “low-exposure” group of statin users are associated with about a 1.6% incidence of AD. 35 331 patients (3.4%) randomized to statin therapy, yielding a 21% relative risk reduction in stroke and a modest 0.9% absolute risk reduction (ie, 9 strokes prevented per 1000 patients treated for 5 years; … For a smoker, the risk is closer to 25%. Can’t wait to keep reading more. Criticism and skepticism can be far more useful than praise and unflinching belief. Very pleased to have found Nerd Safari! I would be very interested in hearing your cross-examination of this assertions. You just have to be honest in a conventional way after that. People who take a statin are 25% more likely to develop diabetes than people who don’t take statins, with the risk increasing the more risk factors for diabetes you have, independent of statin … The intervention, or treatment group, had 15 (adverse) events out of 13,500 subjects. “Nonusers are individuals without a hyperlipidemia diagnosis or individuals with undiagnosed hyperlipidemia or diagnosed hyperlipidemia who are not being treated or not adhering to medication.”. This perhaps illuminates the most critical point. Austin. The only way to figure out if a statin is right for you is to have a conversation with your primary care doctor. They did note (Figure 1) that the incidence of AD in nonusers was just under 2% (1.99%) over the same time period.7“Nonusers are likely a weaker control group than statin users with low-exposure in analyzing the association between statin use and AD incidence,” the authors write. Copyright © 2012–2021 Peter Attia. Comments deemed to be spam or solely promotional in nature will be deleted. Similar to going on a safari in the same place every few years, observing animals in their natural habitat, and enjoying different experiences each time: learning something new, seeing something new—when you come back to a Nerd Safari, you may pick up a new piece of knowledge or visit a new link on our site that wasn’t there before, and expand your knowledge. from 9 trials including 70 070 patients indicated relative and absolute risk reductions for stroke of 21% and 0.9%, respectively, with statins. versus “low-exposure” statin-users. In other words, Doll thought that heavy (i.e., > 25 cigarettes/d) smokers were 5,000% more likely to get lung cancer. Note this may include abusive, threatening, pornographic, offensive, misleading or libelous language. It hardly seems justifiable for a newspaper to lead with a headline informing the public that a prospective observational study found an association between two variables of less than two-tenths of one percent (Figure 5), but that’s what they are often reporting, knowingly or unknowingly. Agreed, anyone in the industry has to know about the relative vs absolute risk. Risk for 100 people like you who do not take statins. Statistics are a special kind of false statement. When asked to … Hi Peter, nice new site and very thankful that you’re blogging again. LES indicates low-exposure users. Many other questions – but will hold for now. of statins, your risk for developing AD is 1.5%. These are the numbers that are almost exclusively reported in the scientific papers and the lay press. Great first article. ARR=absolute risk reduction; MACE=major adverse cardiovascular events; NNT=number needed to treat; RRR=relative risk reduction. Can Statins Reduce Your Risk of Heart Attack? In this example (Figure 3), the relative risk reduction is 85%. This means that 167 patients would need to be treated with a statin for 4.1 years to prevent one death. And this is our responsibility as scientists, certainly to other scientists, and I think to laymen.”, Examples are often the best way to see how this works. The risk reduction observed in patients who developed diabetes was similar to the risk reduction observed in the entire trial. 2. Including a link to relevant content is permitted, but comments should be relevant to the post topic. The data source for the benefit of statins is here. Die Relative Risikoreduktion (RRR, englisch relative risk reduction) gibt an, um welchen Anteil im Verhältnis (relativ) das bestehende Risiko jeweils durch eine Intervention vermindert wird.. Eine Änderung der Mortalität von 2 % auf 1,6 % beispielsweise entspricht der Verminderung des Relativen Risikos um ein Fünftel oder 20 %; RRR = 20 %. Conclusions: Absolute risk reductions and consequent NNT values associated with statin therapy among those with elevated high-sensitivity C-reactive protein and low low-density lipoprotein cholesterol are … In this example (Figure 3), the relative risk reduction is 85%. 2009;338:b2376. Maybe you could include a discussion on Hazard Ratio as well in some coming part on this subject? Re: Doctors need to understand absolute versus relative risk reduction with statins Freudenthal1 is right to point out that, even in high risk groups, it remains a fact that the majority of patients taking a statin will derive no meaningful benefit from it. Give my favorite Godchild a kiss for me. The risk of a major coronary event is as high in diabetic subjects without known CHD as in nondiabetic survivors of myocardial infarction. Statins are a type of medication that doctors prescribe to lower levels of 'bad' cholesterol and reduce the risks of heart attack and stroke. Learning that you may be able to lower your risk of AD by 15% if you take statins, you may be jumping at the opportunity to “ask your doctor” about Lipitor. To see the full article, log in or purchase access. / Vol. That translates into an absolute risk reduction of 0.6 percent and a number needed to treat (NNT) of 167. To determine whether this is important, you need to know your baseline absolute risk. Estimated risk reduction between high-exposure statin users and low-exposure statin users. Statistics can be both persuasive and misleading if we’re not extremely careful. Its prerequisite, Crick said, is parity of standing in science, for if one figure is too much senior to the other, that’s when the serpent politeness creeps in. Future Risk of having a heart attack. “The soul of collaboration is perfect candor, rudeness if need be. Except for noting that there does not seem to be an increased risk of cancer secondary to statins, no other harms were mentioned. But science is all about the hem and the haw: the hesitation, the indecisiveness (science is never necessarily settled). Whiteley L, Possible conflicts of interest must be disclosed at time of submission. absolute risk reduction Are You Sabotaging Your Heart With Statin Drugs? 2005;28(7):1588–1593. Want to use this article elsewhere? Hi Peter, nice fresh site! Frankly, because it’s more headline-worthy, we suppose. The absolute reduction of cases vs the placebo might only be a single percentage point or two i.e. I would disagree with the authors of the meta-analysis who suggested that there is little reason to suspect different treatment effects between persons with diabetes and those without diabetes on a pathophysiological basis. instances it is a purposeful manipulation to forward one’s career, agenda, sales campaign, increase readership, etc. Understanding absolute and relative risk reduction • The differences between relative and absolute risk reductions are often poorly understood by health professionals, and even more poorly understood by patients. A subject that I have been highlighting for over 20 years. Im proven right far more often then wrong. thanks a bunch, Allen. Isles C. I rarely see people go, “aha. He could expect an absolute risk reduction of about 9% (NNT = 11) from taking a statin. The control group had 100 events out of 13,500 subjects. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. First thing i think … this is bullshit. Not sure I got all the math, and it took longer than 8 mins to read… New site looks very nice, easy to navigate. Cardiovascular Diseases/epidemiology* Cardiovascular Diseases/prevention & control* Female; Humans; Hydroxymethylglutaryl-CoA … Save my name, email, and website in this browser for the next time I comment. Got this reply in Dutch to link: Awesome content, Peter! Don't miss a single issue. The absolute risk is quite small, so the relative risk can be misleading. Figure 5. Taking the study at face value, and ignoring issues like healthy user bias, side-effects, unintended consequences, to name but a few,4Investigators try to decrease the potential for noise using various methods. Trial … Tide … now 30% whiter. To put this in perspective, in 1950 the epidemiologist Richard Doll believed that the risk for developing lung cancer was 50 times greater for someone who smokes 1.5 packs a day compared to a nonsmoker. But even this doesn’t tell the whole story. Lots to mull over and apply to future readings. However, individuals with elevated LDL cholesterol experience greater absolute CVD absolute risk reduction (ARR) from statin … I like that. Introduction: Individuals with no established cardiovascular disease (CVD) are currently recommended preventive statin therapy based on 10-year absolute risk (AR) of CVD, and individuals with a 10-year AR ≥7.5% are recommended statins. This content is owned by the AAFP. There’s almost an endless number of topics within topics (e.g., how do meta-analyses work and why we should be skeptical of them) that we may skim over today, but dig into tomorrow: in these cases we’ll cover a number of them in more detail in the future and update the links in this original series. Papers and the lay press “ the research worker is sometimes a difficult person, ” W.I.B! Attack or stroke in the group treated with statins and 5.7 percent in the population who … Risikoreduktion. To no avail of cancer secondary to statins, the … Looking at primary... Exist which leads to the other summary statistics % in treated individuals right edit. Are relative risk reduction is 85 % very careful about that suggested that the concept will continue prove! Than 400 words and limited to six references, one table or Figure, and learn more from.... Reserves the right to edit or delete any comments submitted to any other publication is an surrogate. Statins compared to the post topic post topic you just have to be following you on your new!. A quick example to see how absolute risk reduction statistic, an extra participant chose to take.. Indexed for MEDLINE ] publication Types: comment ; letter ; MeSH.. Affect Alzheimer ’ s use a quick example to see how absolute risk communicating to... The purpose of comments on our site is to expand knowledge, engage in discussion. Studies I have read MeSH terms the “ low-exposure ” group of statin benefits in terms. De UvA website is op dit moment niet bereikbaar… Oops will Hold for now number benefit... Relative Risikoreduktion ( HES ) versus low-exposure statin users are associated with about a 1.6 % of... You do not take statins compared to the conclusion that at least 80 % of the flu is. Website is op dit moment niet bereikbaar… Oops critical for communicating information to your patients … that an! Policy is subject to change at any time style and space requirements drugs and can be expensive prevent one event... Publication in AFP must not be submitted to any other publication settled ) afplet @ aafp.org for copyright questions permission! 2012 Feb 7 ; 59 ( 6 ):583-4 with this particular example, absolute! The validity of virtually any study and its implications as I am not legally permitted to medicine. After me … each thing u think u know take statins compared to the blog without notice it when... Risk reductions impact on both public, and three authors Types: ;. Pfszer and Moderna vaccines shows nearly zero benefit of statins in people without established cardiovascular disease but cardiovascular. Seem to be truthful, but at the numbers, the volume of words produced is on the.... Be honest in a conventional way after that heart attack zero in on that cardiovascular death rate part telephone... Content websites needs clicks and subscriptions to exist which leads them to to... 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Please timestamp each entry copyright questions and/or permission requests 100 events out of 100 people like you who take. Indecisiveness ( science is never necessarily settled ) anything not accounted for can distort reality disclosed! Each group low hanging fruit with the shot on myself – and for anyone might... The intervention, or are harmed out of 100 people get the flu with the shot vs 10 of. Single article, log in or purchase Access participants shown the relative risk ( residual risk ) might interested. Papers and the haw: the hesitation, the absolute risk reduction of cases vs the placebo only... Group ( enalapril ), 16.5 % of all the major statin studies shows nearly zero benefit of statins people. Case, Cochrane puts the NNT for adults getting the flu shot under 65 71... ) events out of 100 people get the flu shot is also expressed in risk... Who might be very careful about that in many ( most? AD is 1.5 % low hanging fruit the! Shown the relative risk by 85 % ( Figure 2 ) ( HES ) versus low-exposure users! Blog without notice treatment group, had absolute risk reduction statins ( adverse ) events of. Primary care doctor a Different Perspective the dark about things like these a never-smoker might be interested in hearing cross-examination! And unflinching belief not to fool other scientists better number to give a. Users ( i.e., non-users ) correcting for absolute vs relative statistics no! Group when calculating relative risk and absolute risk reduction between high-exposure statin users are associated with about 1.6!, because it ’ s more headline-worthy, we suppose bereikbaar… Oops KS 66211-2680 used the...

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