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 .
Effects of simvastatin 40 mg daily on muscle and liver adverse effects in a 5-year randomized placebo-controlled trial in 20,536 high-risk people
Background Simvastatin reduces cardiovascular mortality and morbidity but , as with other HMG-CoA reductase inhibitors , can cause significant muscle toxicity and has been associated with elevations of liver transaminases . Methods Muscle and liver adverse effects of simvastatin 40 mg daily were evaluated in a r and omized placebo-controlled trial involving 20,536 UK patients with vascular disease or diabetes ( in which a substantial reduction of cardiovascular mortality and morbidity has previously been demonstrated ) . Results The excess incidence of myopathy in the simvastatin group was < 0.1 % over the 5 years of the trial , and there were no significant differences between the treatment groups in the incidence of serious hepatobiliary disease . Conclusion Among the many different types of high-risk patient studied ( including women , older individuals and those with low cholesterol levels ) , there was a very low incidence ( < 0.1 % ) of myopathy during 5 years treatment with simvastatin 40 mg daily . The risk of hepatitis , if any , was undetectable even in this very large long-term trial . Routine monitoring of liver function tests during treatment with simvastatin 40 mg is not useful . Trial Registration IS RCT
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 .