Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects .
There was no evidence of any serious harm caused by statin prescription .
Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life .
Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event .
AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins
BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy .
Statins are the first-choice agents .
Previous review s of the effects of statins have highlighted their benefits in people with CVD .
The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required .
OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .
Expanded clinical evaluation of lovastatin (EXCEL) study results: III. Efficacy in modifying lipoproteins and implications for managing patients with moderate hypercholesterolemia.
In the multicenter , double-blind EXCEL ( Exp and ed Clinical Evaluation of Lovastatin ) study the efficacy of lovastatin in modifying plasma lipids and lipoproteins in 8,245 participants with moderate primary hypercholesterolemia was evaluated . Patients were r and omly assigned to 48 weeks of treatment with diet and placebo or diet and lovastatin 20 or 40 mg once a day , or 20 or 40 mg twice a day . At all of these dosages , lovastatin produced substantial dose-dependent reductions in low-density-lipoprotein (LDL)-cholesterol levels , averaging 24 % ( 20 mg/day ) to 40 % ( 80 mg/day ) . The magnitude of the effect of this lipoprotein was further reflected by the percentage of patients who achieved National Cholesterol Education Program ( NCEP ) goals . In the absence of coronary artery disease ( CAD ) or two other CAD risk factors , the LDL-cholesterol goal of 4.14 mmol/L ( 160 mg/dL ) was attained by 22 % of patients in the placebo group and between 81 % ( 20 mg/day ) and 96 % ( 80 mg/day ) of those treated with lovastatin . For those with CAD or at least two other CAD risk factors , the LDL-cholesterol goal of 3.36 mmol/L ( 130 mg/dL ) was attained by 4 % of placebo patients and between 38 % ( 20 mg/day ) and 83 % ( 80 mg/day ) of those treated with lovastatin . Lovastatin also increased high-density-lipoprotein cholesterol ( 7 - 10 % ) and decreased triglycerides ( 10 - 19 % ) in a dose-dependent manner . Thus , when used as an adjunct to a prudent diet , lovastatin produces favorable changes in the entire lipoprotein profile and is a highly effective agent for managing patients with primary hypercholesterolemia
Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects .
There was no evidence of any serious harm caused by statin prescription .
Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life .
Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event .
AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins
BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy .
Statins are the first-choice agents .
Previous review s of the effects of statins have highlighted their benefits in people with CVD .
The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required .
OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .