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 .
Effect of lovastatin on early carotid atherosclerosis and cardiovascular events. Asymptomatic Carotid Artery Progression Study (ACAPS) Research Group.
BACKGROUND HMG CoA reductase inhibitors ( or statins ) , a new class of lipid-lowering compounds , have raised expectations for more widespread use than that of the older lipid-lowering drugs . Not only are they more effective in lowering LDL cholesterol , but they are better tolerated as well . No data exist concerning the effect of statins on early carotid atherosclerosis and clinical events in men and women who have moderately elevated LDL cholesterol levels but are free of symptomatic cardiovascular disease . METHODS AND RESULTS Lovastatin ( 20 to 40 mg/d ) or its placebo was evaluated in a double-blind , r and omized clinical trial with factorial design along with warfarin ( 1 mg/d ) or its placebo . This report is limited to the lovastatin component of the trial . Daily aspirin ( 81 mg/d ) was recommended for everyone . Enrollment included 919 asymptomatic men and women , 40 to 79 years old , with early carotid atherosclerosis as defined by B-mode ultrasonography and LDL cholesterol between the 60th and 90th percentiles . The 3-year change in mean maximum intimal-medial thickness ( IMT ) in 12 walls of the carotid arteries was the primary outcome ; change in single maximum IMT and incidence of major cardiovascular events were secondary outcomes . LDL cholesterol fell 28 % , from 156.6 mg/dL at baseline to 113.1 mg/dL at 6 months ( P < .0001 ) , in the lovastatin groups and was largely unchanged in the lovastatin-placebo groups . Among participants not on warfarin , regression of the mean maximum IMT was seen after 12 months in the lovastatin group compared with the placebo group ; the 3-year difference was statistically significant ( P = .001 ) . A larger favorable effect of lovastatin was observed for the change in single maximum IMT but was not statistically significant ( P = .12 ) . Five lovastatin-treated participants suffered major cardiovascular events -- coronary heart disease mortality , nonfatal myocardial infa rct ion , or stroke -- versus 14 in the lovastatin-placebo groups ( P = .04 ) . One lovastatin-treated participant died , compared with eight on lovastatin-placebo ( P = .02 ) . CONCLUSIONS In men and women with moderately elevated LDL cholesterol , lovastatin reverses progression of IMT in the carotid arteries and appears to reduce the risk of major cardiovascular events and mortality . Results from ongoing large-scale clinical trials may further establish the clinical benefit of statins
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 .