WOSCOPS is touted as the first great statin trial to show reduction in total mortality. But look carefully at the numbers.
Why was Scotland chosen as the location for the trial? Scotland has one of the worst lifestyles and the worst rate of coronary disease (heart attacks) on the planet. That’s why Scotland was chosen for the trial, not rural Vietnam where there were no heart attacks.
No real attempt was made to change this awful lifestyle except for “lipid-lowering dietary advice”. The average BMI was 26, so most subjects were overweight or obese, a major risk factor. All subjects should have had a BMI less than 25 and/or waist circumferences less than half their heights and demonstrated to be on a non-atherogenic diet BEFORE the trial. Since they weren’t, the trial was UNETHICAL.
P=0.051 is NOT statistically significant. By the magic of statistics, a 1% absolute reduction in mortality is converted into a 22% relative reduction in mortality. No mention is made of cost but it would cost about $US 500,000 in drug cost to obtain this miniscule reduction in mortality.