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 .
Intima-media thickness after pravastatin stabilizes also in patients with moderate to no reduction in LDL-cholesterol levels: the carotid atherosclerosis Italian ultrasound study.
The Carotid Atherosclerosis Italian Ultrasound study ( CAIUS ) , a multicenter , double-blind clinical trial , performed in 305 asymptomatic , moderately hypercholesterolemic patients , clearly demonstrated beneficial effects of pravastatin on the carotid intima-media thickness ( IMT ) progression . The data base of the CAIUS study was examined in order to investigate the presence of a relationship , if any , between the activity of pravastatin on IMT progression rate and its hypocholesterolemic effect . Quantitative B-mode ultrasound imaging was used to quantify the individual mean maximum IMT progression rate in 3 years . In the overall group of patients ( placebo and pravastatin ) covariance analysis showed that while the variable ' treatment ' ( 0 = placebo , 1 = pravastatin ) was significantly related to the reduction of IMT progression ( F= 6.6 , P = 0.01 ) , the IMT progression did not correlate with the extent of LDL-C lowering ( F= 0.00 , P = 0.98 ) . To further investigate this issue . the pravastatin treated group was stratified into quartiles of LDL-C reduction . In contrast to what was observed in the placebo group , in which a positive mean IMT progression rate was observed , independent of the extent of LDL-C reduction , no IMT progressionwas observed in any subgroup treated with pravastatin . No significant difference was found among quartiles and no trend could be identified . In conclusion , the effect of pravastatin treatment on carotid IMT progression rate is beneficial ; however the CAIUS study demonstrated that lowering LDL-C by itself , does not explain the variability of beneficial changes in IMT
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 .