Question
My UK doctor offered me a statin but I don’t think I need them?
25 April 2025. Related: All topics, Complications and coinfections, Living with HIV long-term.
Hi there
At my most recent checkup I was asked if I wanted to start to take statins. I don’t have any health conditions, apart from HIV. I’m fit, healthy, Â have normal blood pressure and don’t smoke.
I was told people living with HIV have a higher risk of cardiovascular issues, Isn’t this a big generalisation? My risk of having a heart attack in the next 10 years is 10%, hip fracture 0.6% and osteoarthritis 4.6%.
I’m 62, was diagnosed 2018, am on Biktarvy and undetectable and I I don’t think I need them?
Answer
Hi there
Thanks – and for letting us answer online.
This is a very relevant question because of a very large HIV study called REPRIEVE. Two years ago this study reported that a statin significantly reduced the risk of serious heart disease, even in people at low risk.
This led to UK guidance in 2023 and 2024 that included offering a statin more widely to all people living with HIV. This includes anyone older than 40 and even if they were at a relatively low risk
The guidance recognised that not everyone would want to do this. Heart disease is linked to many different factors and this needs a holistic approach. Some people prefer to make changes to diet and exercise, or other lifestyle changes. Other risk factors include things like family history and cholesterol levels, which you didn’t mention.
The study results were so important though that they were to make sure that HIV doctors had these discussions. It is good that your doctor did this. Hopefully your doctor also included examples of how a statin would reduce your current risk..
The US study enrolled people whose risk was less than 5% and the study was stopped early because the benefit of the statin became clear earlier than expected.
Whether or not you decide this is right for you will of course be up to you. But it would be good for the doctor to include how effectively the statins work compared to a very low risk of side effects.
Although in general people living with HIV are at increased risk in general, your doctor is focussed on your individual risk, which at 10% is considered quite high.
Link to BHIVA statement:
BHIVA rapid guidance on the use of statins for primary prevention of cardiovascular disease in people living with HIV
https://bhiva.org/rapid-guidance/bhiva-rapid-guidance-on-the-use-of-statins-for-primary-prevention-of-cardiovascular-disease/
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