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 .
Simvastatin therapy for hypercholesterolemic patients with nephrotic syndrome or significant proteinuria.
Experimental evidence suggests that lipid lowering therapy could slow the progression of renal disease in humans . We have conducted a double-blind , placebo controlled trial of the HMG CoA reductase inhibitor simvastatin in patients with the nephrotic syndrome or significant proteinuria ( > 1 g/day ) and hypercholesterolemia ( > or = 6.5 mmol/liter ) . Patients were placed on a lipid lowering diet for at least 10 weeks before r and omization . After a four-week placebo run-in , 30 adults were r and omized to simvastatin or placebo therapy ( 10 mg/day , increasing to 20 to 40 mg/day as required ) for 24 weeks . There were seven dropouts , none of whom were " definitely " related to drug therapy . Total and LDL cholesterol levels fell by a mean of 33 and 31 % , respectively , in simvastatin treated patients , compared with only 5 and 1 % in patients on placebo ( P < 0.001 , P = 0.002 , respectively ) . Apolipoprotein B100 levels fell by a mean of 31 % in the simvastatin group but rose 0.3 % in the placebo group ( P = 0.014 ) . There were no significant changes in HDL levels . There were no significant differences between the groups in their urine protein levels , their rise in plasma creatinine , or decline in plasma inulin clearance .  Simvastatin is a safe , effective therapy for hypercholesterolemia in proteinuric states . A much larger trial is needed to show if potent lipid-lowering therapy slows progression of hypercholesterolemic proteinuric diseases
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 .