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 .
The JUPITER Trial: responding to the critics.
p w A s l fi r t t u w h In January 2003 , the Justification for the Use of statins in revention : an Intervention Trial Evaluating Rosuvastatin JUPITER ) investigators began to enroll 17,802 men and omen with no evidence of cardiovascular disease and ormal to low levels of low-density lipoprotein ( LDL ) choesterol into a controversial trial testing whether subjects ith enhanced inflammatory responses might benefit from ggressive statin therapy . At study entry , the mean LDL holesterol level for enrolled participants was just above 00 mg/dl , nearly half had Framingham scores of 10 % , nd none were considered c and i date s for statin therapy under ny current set of prevention guidelines . However , all trial articipants had levels of the inflammatory biomarker highensitivity C-reactive protein ( hsCRP ) 2 mg/L , putting them t substantial risk for future cardiovascular disease . As the JUPITER investigators have since reported in a eries of rigorously peer- review ed reports published in the ew Engl and Journal of Medicine , The Lancet , the nnals of Internal Medicine , Circulation , the Journal of he American College of Cardiology , and The American ournal of Cardiology , r and om allocation to rosuvastatin 0 mg compared to placebo within the trial population esulted in a 54 % reduction in myocardial infa rct ion ( p .0002 ) , a 51 % reduction in ischemic stroke ( p 0.004 ) , a 6 % reduction in need for bypass surgery or angioplasty p 0.0001 ) , a 43 % reduction in venous thromboembolism p 0.002 ) , and a 20 % reduction in all-cause mortality p 0.02 ) . For the JUPITER primary end point of
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 .