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 .
Measuring the cost-effectiveness of lipid-lowering drugs in the elderly: the outcomes research and economic analysis components of the PROSPER trial.
Little information exists to quantify the functional status and economic consequences of lipid-lowering therapy in elderly patients . We describe the design of the cost-effectiveness component of the first large , r and omized , placebo-controlled trial of lipid-lowering therapy in subjects aged 70 years or older . The PROspect i ve Study of Pravastatin in the Elderly at Risk has r and omized 5804 men and women 70 - 82 years old , with existing vascular disease or related risk factors , to receive 40 mg/d of pravastatin or placebo . The cost-effectiveness study will be based on within-trial observations of differences between the two study arms in rates of myocardial infa rct ion , stroke and related vascular disease outcomes ( including vascular dementia ) . In addition to comparing within-trial clinical outcomes , we will model the projected changes in life expectancy and cardiovascular outcome rates that would be seen with lifelong use of the drug , based on the risk reduction rates seen in the trial as well as baseline observational data from the three countries where the trial is being conducted ( Scotl and , Irel and and the Netherl and s ) . A state transition ( Markov ) model will be constructed to estimate the likely states of health , functional status and health care re source utilization ( including lipid-lowering drug costs ) in a cohort of elderly patients with versus without pravastatin therapy over a series of 1-year cycles until death . In addition , a st and ard measure of utility ( the Health Utilities Index ) will be administered to all study subjects to permit calculation of quality -adjusted life-years gained with this regimen . This approach will make it possible to go beyond the calculation of a single endpoint for each subject , and to translate the trial findings into definitions of effectiveness and outcomes that will be relevant to the ongoing debate concerning how best to relate the benefits of such medications to their costs
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 .