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 .
Simvastatin in the treatment of asthma: lack of steroid-sparing effect
Background Statins have anti-inflammatory actions which in theory are potentially beneficial in asthma . Small trials have failed to show a significant benefit , but a systematic study to evaluate the steroid-sparing effect of statin treatment has not been carried out . Methods A r and omised , placebo-controlled , crossover trial was conducted of simvastatin 40 mg at night with simultaneous stepwise reduction of fluticasone propionate dose until loss of control occurred , followed by an increase until regain of control ( ‘ minimum ’ dose required ) in 51 patients with asthma and sputum eosinophils ( steroid-free ) ≥2 % . Results 43 patients completed the study . There was no significant difference in ‘ minimum ’ inhaled corticosteroid ( ICS ) dose requirement  between simvastatin and placebo : ( median ( IQR ) 50 μg daily ( 0–250 ) vs 100 μg daily ( 0–250 ) , p=0.931 ) . ‘ Minimum ’ dose distribution was similar ( p=0.269 ) . The fluticasone dose at which loss of control occurred did not differ significantly between simvastatin and placebo ( p=0.404 ) . In patients with loss of control in both treatment arms , fluticasone dose at loss of control was similar with simvastatin and placebo ( median ( IQR ) 50 μg daily ( 0–100 ) for both , p=0.620 ) . In those patients who reached 0 μg/day ( n=18 ) , Astma Control Question naire ( ACQ ) was lower ( p=0.037 ) , forced expiratory volume in 1 s ( FEV1 ) higher ( p<0.01 ) and sputum eosinophils lower with simvastatin compared with placebo ( 9.5 % compared with 25.4 % , p=0.033 ) . Conclusions Simvastatin does not have clinical ly important steroid-sparing effects in patients with eosinophilic asthma . In the absence of steroid , simvastatin is associated with minor improvements in symptoms and lung function , and a reduction in sputum eosinophils . Clinical trial number ACTRN12606000531516
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 .