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 .
Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study.
BACKGROUND In several statin trials , vascular event rates for treatment groups begin to separate 1 year after commencement of treatment . For atherosclerosis progression , the temporal sequence of the effect has not been defined . We used data from the Measuring Effects on intima media Thickness : an Evaluation Of Rosuvastatin ( METEOR ) trial to determine the earliest time point at which significant differences in atherosclerosis progression rates could be detected after initiation of statin therapy . METHODS The METEOR trial was a double-blind , r and omized placebo-controlled trial that studied the effect of LDL-C lowering with 40 mg rosuvastatin on the rate of change of carotid intima media thickness ( CIMT ) measured by B-mode ultrasound amongst 984 low risk subjects . Ultrasound assessment s were made at baseline and every 6 months up to 2 years . RESULTS Rosuvastatin treatment was associated with a 49 % reduction in LDL-C-C , a 34 % reduction in total cholesterol , an 8.0 % increase in HDL-C and a 16 % reduction in triglycerides ( all P < 0.0001 compared with placebo ) . The difference in rate of mean maximum CIMT progression between the rosuvastatin and placebo groups ( based on near and far wall measurements from both left and right common carotid and internal carotid segments and carotid bifurcation ) was not statistically significant after 6 months ( 0.0023 mm year(-1 ) and 0.0106 mm year(-1 ) , respectively P = 0.34 ) . After 12 months , CIMT progression rates were significantly different between the groups : 0.0032 mm year(-1 ) and 0.0133 mm year(-1 ) in the rosuvastatin-treated and placebo-treated groups , respectively ( P = 0.049 ) . This divergence grew with further follow-up : -0.0009 mm year(-1 ) and 0.0131 mm year(-1 ) after 18 months ( P < 0.001 ) and -0.0014 mm year(-1 ) and 0.0131 mm year(-1 ) after 24 months of treatment ( P < 0.001 ) . Results were stronger for the mean common CIMT progression ( based on near and far wall measurements from both left and right common carotid segments ) . CONCLUSION Aggressive LDL-C lowering seems to exert its beneficial effect on atherosclerosis progression during the first 12 months of treatment . This parallels the timing of event reduction seen in clinical trials and suggests that the efficacy of lipid lowering treatment on CIMT progression can be evaluated in trials with a duration of 1 year , given sufficient sample size , high precision of measurements and a treatment effect comparable to that seen in METEOR
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 .