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 .
[Pravastatin in the treatment of primary hypercholesterolemia: a Swiss multicenter study].
Conventional lipid-lowering agents displayed only limited efficacy in lowering total and LDL cholesterol and a high incidence of side effects .  Pravastatin is a new potent cholesterol-lowering agent , which selectively inhibits hepatic HMG-CoA-reductase . In a double-blind , placebo-controlled Swiss multicenter study with determination of lipids and lipoprotein in a central laboratory , the efficacy and safety of 6 months ' therapy with pravastatin was evaluated in 50 patients with mild hypercholesterolemia and additional coronary risk factors . Compared to baseline and after 26 weeks ' therapy , pravastatin significantly reduced total cholesterol  ( pravastatin vs placebo , -17 % vs + 7 % , p < 0.0001 ) and LDL cholesterol ( -26 vs + 2 % , p < 0.0001 ) . The total/HDL cholesterol ratio ( = " atherogenic index " ) was comparable in the two groups at baseline ( 5.9 + /- 1.1 vs 6.3 + /- 0.9 ) , and was distinctly lowered by pravastatin but not placebo ( -20 vs 0 % , p < 0.0001 ) . In 11 patients in whom the reduction of serum total cholesterol after 13 weeks ' treatment with 20 mg pravastatin was still below target ( on average -9.1 % ) , doubling of the dose produced a further decrease of 4.3 % . Serum HDL cholesterol and serum triglyceride levels did not change significantly during pravastatin treatment as compared to baseline and placebo . Pravastatin was well tolerated during the 26 weeks without relevant subjective side-effects . There were 5 dropouts during the study , 2 patients in the pravastatin group and 3 in the placebo group . These findings document that pravastatin , administered in a single daily dose of 20 to 40 mg , effectively lowers serum cholesterol and total-/HDL-cholesterol improving action and is well tolerated
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 .