Is there sufficient enhancement of the reduction in CVD rates after a decade of statin therapy to justify continuation?

Randomized, controlled clinical trials have shown significant benefits of statin therapy in patients with or at risk for atherosclerotic cardiovascular disease (ASCVD). But these trials typically enroll patients for only 5 years or so, prompting some clinicians to ask what the longer term follow-up of these patients will show. While most trials have a duration of only approximately 5 years, four large trials report extended post-trial follow-up to 10 years, and these trials, as well as multiple large cohort studies, suggest an expected benefit of statins' effects beyond 10 years. In this review we will summarize the current state of the literature, the benefits noted to date, and the potentially accumulating, adverse effects of long-term statin use.