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 .
Effects of atorvastatin on bone in postmenopausal women with dyslipidemia: a double-blind, placebo-controlled, dose-ranging trial.
CONTEXT In pre clinical models , inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A reductase have been shown to positively affect bone remodeling balance . Observational studies and secondary analyses from lipid-lowering trials have yielded inconsistent results regarding the effect of these agents on bone mineral density and fracture risk . OBJECTIVE Our objective was to determine whether clinical ly significant skeletal benefits result from hydroxymethylglutaryl-coenzyme A reductase inhibition in postmenopausal women . DESIGN AND SETTING We conducted a prospect i ve , r and omized , double-blind , placebo-controlled , dose-ranging comparative clinical trial at 62 sites in the United States . PARTICIPANTS Participants included 626 postmenopausal women with low-density lipoprotein cholesterol levels of at least 130 mg/dl ( 3.4 mmol/liter ) and less than 190 mg/dl ( 4.9 mmol/liter ) , and lumbar ( L1-L4 ) spine bone mineral density T-score between 0.0 and -2.5 . INTERVENTION Once-daily placebo or 10 , 20 , 40 , or 80 mg atorvastatin was administered . MAIN OUTCOME MEASURES We assessed percent change from baseline in lumbar ( L1-L4 ) spine bone mineral density with each dose of atorvastatin compared with placebo . RESULTS At 52 wk , there was no significant difference between each atorvastatin and placebo group or change from baseline at any tested dose of atorvastatin or placebo in lumbar ( L1-L4 ) spine bone mineral density . Nor did atorvastatin produce a significant change in bone mineral density at any other site . Changes in biochemical markers of bone turnover did not differ significantly between each atorvastatin and placebo group . All doses of atorvastatin were generally well tolerated , with similar incidences of adverse events across all dose groups and placebo . CONCLUSIONS Clinical ly relevant doses of atorvastatin that lower lipid levels had no effect on bone mineral density or biochemical indices of bone metabolism in this study , suggesting that such oral agents are not useful in the prevention or treatment of osteoporosis
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 .