HQ Team
November 9, 2024: A recent study indicates that rosuvastatin is associated with a slightly reduced risk of all-cause mortality and major cardiovascular events compared to atorvastatin, while both medications carry similar risks for chronic kidney disease.
The multi-database retrospective cohort study analyzed data from the UK Biobank and the China Renal Data System, focusing on the effects of atorvastatin and rosuvastatin on various health outcomes. The study included over 285,000 participants aged 16 and older who began treatment between 2006 and 2022.
Study findings
Rosuvastatin users showed a slightly decreased risk of all-cause mortality and major adverse cardiovascular events (MACEs) compared to those on atorvastatin.
Both statins had similar risks for developing chronic kidney disease (CKD).
British participants starting on rosuvastatin had a higher risk of developing type 2 diabetes compared to atorvastatin users, a trend not observed in Chinese participants.
The risk difference for rosuvastatin was -1.03% in the Chinese cohort and -1.38% in the UK cohort, indicating a lower mortality rate.
Rosuvastatin users had lower rates of major adverse cardiovascular events with risk differences of -0.94% in China and -2.11% in the UK.
Both medications showed similar risks for CKD development.
A notable increase in Type 2 Diabetes risk was found among British participants using rosuvastatin.
Background
Rosuvastatin and atorvastatin are the two most powerful statins prescribed for coronary heart disease. Statins are originally from fungi.
Globally, statin utilisation increased 24.7% from 54.7 DDDs/TPD in 2015 to 68.3 DDDs/TPD in 2020. Statin utilisation was measured using defined daily doses (DDDs) per 1000 population ≥40 years per day (TPD).
However, regional and income group disparities persisted during this period. In 2020, statin utilisation was more than six times higher in HICs (higher income) than LMICs (lower/mid income), 192.4 vs 28.4 DDDs/TPD, p<0.01.
Earlier studies have also shown that rosuvastatin appears to do a better job at lowering cholesterol levels, but is associated with an increased risk of diabetes and cataracts.
Lowering LDL cholesterol levels — “bad” cholesterol — is an important therapeutic goal in the treatment of coronary heart disease, and rosuvastatin may thus be the statin of choice for many.
But the present study highlights the need for careful consideration when prescribing these medications, particularly regarding their potential side effects.
