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 .
Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial
BACKGROUND Evidence -based treatment for hypercholesterolaemia in Japan has been hindered by the lack of direct evidence in this population . Our aim was to assess whether evidence for treatment with statins derived from western population s can be extrapolated to the Japanese population . METHODS In this prospect i ve , r and omised , open-labelled , blinded study , patients with hypercholesterolaemia ( total cholesterol 5.69 - 6.98 mmol/L ) and no history of coronary heart disease or stroke were r and omly assigned diet or diet plus 10 - 20 mg pravastatin daily . The primary endpoint was the first occurrence of coronary heart disease . Statistical analyses were done by intention to treat . This trial is registered at Clinical Trials.gov , number NCT00211705 . FINDINGS 3966 patients were r and omly assigned to the diet group and 3866 to the diet plus pravastatin group . Mean follow-up was 5.3 years . At the end of study , 471 and 522 patients had withdrawn , died , or been lost to follow-up in the diet and diet plus pravastatin groups , respectively . Mean total cholesterol was reduced by 2.1 % ( from 6.27 mmol/L to 6.13 mmol/L ) and 11.5 % ( from 6.27 mmol/L to 5.55 mmol/L ) and mean LDL cholesterol by 3.2 % ( from 4.05 mmol/L to 3.90 mmol/L ) and 18.0 % ( from 4.05 mmol/L to 3.31 mmol/L ) in the diet and the diet plus pravastatin groups , respectively . Coronary heart disease was significantly lower in the diet plus pravastatin group than in the diet alone group ( 66 events vs 101 events ; HR 0.67 , 95 % CI 0.49 - 0.91 ; p=0.01 ) . There was no difference in the incidence of malignant neoplasms or other serious adverse events between the two groups . INTERPRETATION Treatment with a low dose of pravastatin reduces the risk of coronary heart disease in Japan by much the same amount as higher doses have shown in Europe and the USA
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 .