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 .
Expanded Clinical Evaluation of Lovastatin (EXCEL) study results. I. Efficacy in modifying plasma lipoproteins and adverse event profile in 8245 patients with moderate hypercholesterolemia.
In the Exp and ed Clinical Evaluation of Lovastatin ( EXCEL ) Study , a multicenter , double-blind , diet- and placebo-controlled trial , we evaluated the efficacy and safety of lovastatin in 8245 patients with moderate hypercholesterolemia . Patients were r and omly assigned to receive placebo or lovastatin at a dosage of 20 mg once daily , 40 mg once daily , 20 mg twice daily , or 40 mg twice daily for 48 weeks . Lovastatin produced sustained , dose-related ( P less than .001 ) changes as follows ( for dosages of 20 to 80 mg/d ) : decreased low-density lipoprotein-cholesterol level ( 24 % to 40 % ) , increased high-density lipoprotein-cholesterol level ( 6.6 % to 9.5 % ) , decreased total cholesterol level ( 17 % to 29 % ) , and decreased triglyceride level ( 10 % to 19 % ) . The National Cholesterol Education Program 's low-density lipoprotein-cholesterol level goal of less than 4.14 mmol/L ( 160 mg/dL ) was achieved by 80 % to 96 % of patients , while the less than 3.36 mmol/L ( 130 mg/dL ) goal was achieved by 38 % to 83 % of patients . The difference between lovastatin and placebo in the incidence of clinical adverse experiences requiring discontinuation was small , ranging from 1.2 % at 20 mg twice daily to 1.9 % at 80 mg/d . Successive transaminase level elevations greater than three times the upper limit of normal were observed in 0.1 % of patients receiving placebo and 20 mg/d of lovastatin , increasing to 0.9 % in those receiving 40 mg/d and 1.5 % in those receiving 80 mg/d of lovastatin ( P less than .001 for trend ) . Myopathy , defined as muscle symptoms with a creatine kinase elevation greater than 10 times the upper limit of normal , was found in only one patient ( 0.1 % ) receiving 40 mg once daily and four patients ( 0.2 % ) receiving 80 mg/d of lovastatin . Thus , lovastatin , when added after an adequate trial of a prudent diet , is a highly effective and generally well-tolerated treatment for patients with moderate hypercholesterolemia
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 .