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Potential benefits of statins on morbidity and mortality in chronic obstructive pulmonary disease: a review of the evidence

R P Young¹, R Hopkins¹, T E Eaton²

¹ Department of Medicine, University of Auckland, Auckland
² Respiratory Services, Auckland City Hospital, Auckland, New Zealand

Correspondence to:
^{Correspondence to} Dr R Young, Department of Medicine, Auckland Hospital, Private Bag 92019, Auckland, New Zealand; roberty{at}adhb.govt.nz

Studies show reduced forced expiratory volume in 1 s (FEV₁) in patients with chronic obstructive pulmonary disease (COPD) is an important independent predictor of cardiovascular death and is characterised by both pulmonary and systemic inflammation. Evidence shows statins have important anti-inflammatory effects in both the lungs and arteries. Although randomised control trials are yet to be reported, non-randomised studies have consistently shown benefit in COPD patients taking statins compared with those not. These include reductions in both cardiovascular and respiratory morbidity/mortality. Other potential benefits include a reduced decline in FEV₁ and reduced risk of lung cancer. It is argued that confounding by a "healthy user effect" is unlikely to explain the observed benefit. Given the undisputed benefit of statins in high risk populations and the growing body of data suggesting statins may benefit patients with COPD, the question arises "Should statins be considered more often in patients with COPD?".

Keywords: chronic obstructive pulmonary disease; COPD, statins; coronary heart disease; chronic airways disease; pharmacology

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