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 .
The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion.
BACKGROUND Patients with coronary artery disease and abnormalities of serum lipids often have endothelial vasodilator dysfunction , which may contribute to ischemic cardiac events . Whether cholesterol-lowering or antioxidant therapy can restore endothelium-dependent coronary vasodilation is unknown . METHODS We r and omly assigned 49 patients ( mean serum cholesterol level , 209 + /- 33 mg per deciliter [ 5.40 + /- 0.85 mmol per liter ] ) to receive one of three treatments : an American Heart Association Step 1 diet ( the diet group , 11 patients ) ; lovastatin and cholestyramine ( the low-density lipoprotein [LDL]-lowering group , 21 patients ) ; or lovastatin and probucol ( the LDL-lowering-antioxidant group , 17 patients ) . Endothelium-dependent coronary-artery vasomotion in response to an intracoronary infusion of acetylcholine ( 10(-8 ) to 10(-6 ) M ) was assessed at base line and after one year of therapy . Vasoconstrictor responses to these doses of acetylcholine are considered to be abnormal . RESULTS Treatment result ed in significant reductions in LDL cholesterol levels of 41 + /- 22 percent in the LDL-lowering-antioxidant group and 38 + /- 20 percent in the LDL-lowering group ( P < 0.001 vs. the diet group ) . The maximal changes in coronary-artery diameter with acetylcholine at base line and at follow-up were -19 and -2 percent , respectively , in the LDL-lowering-antioxidant group , -15 and -6 percent in the LDL-lowering group , and -14 and -19 percent in the diet group ( P < 0.01 for the LDL-lowering-antioxidant group vs. the diet group ; P = 0.08 for the LDL-lowering group vs. the diet group ) . ( The negative numbers indicate vasoconstriction ) . Thus , the greatest improvement in the vasoconstrictor response was seen in the LDL-lowering-antioxidant group . CONCLUSIONS The improvement in endothelium-dependent vasomotion with cholesterol-lowering and antioxidant therapy may have important implication s for the activity of myocardial ischemia and may explain in part the reduced incidence of adverse coronary events that is known to result from cholesterol-lowering therapy
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 .