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 .
Prognosis of hypercholesterolemic patients taking pravastatin for five years: the Chiba Lipid Intervention Program (CLIP) Study.
The Chiba Lipid Intervention Program ( CLIP ) Study was design ed to clarify the prognosis of Japanese hypercholesterolemic patients taking pravastatin for 5 years . Hypercholesterolemic patients ( n = 2,529 ) with a total cholesterol level > or = 220 mg/dl and without histories of ischemic coronary heart disease and /or cerebral infa rct ion were administered pravastatin ( 10 - 20 mg/day ) . Among them , 2,131 took pravastatin fully ( Pravastatin-continued  group ) , and 398 discontinued the treatment ( Discontinued group ) . The baseline total cholesterol level was 264.3 + /- 34.7 mg/dl ( mean + /- st and ard deviation ) . The mean reduction rates of total cholesterol and low-density lipoprotein ( LDL ) cholesterol were 18.0 % and 27.2 % , respectively . Mild and moderate adverse events occurred in 86 cases ( 3.6 % ) . Serious adverse events were not observed . Death rates of the pravastatin-continued group and of the discontinued group were 2.6 and 16.0/1,000 persons/year , respectively . Cardiac events ( fatal and nonfatal myocardial infa rct ion , cardiac death , angina pectoris ) in all , occurred in 35 patients ( incidence rate = 2.77/1,000 persons/year ) . In the pravastatin continued group , 9 causes of fatal and nonfatal myocardial infa rct ion occurred ( 0.84/1,000 persons/year ) , whereas in the discontinued group , 4 cases occurred ( 2.06/1,000 persons/ year ) . The risk ratio for cardiac events was correlated with the number of risks . In the low-risk group ( < or = 1 risk ) , decreased rates of LDL-cholesterol were less in the cardiac event group than the non-cardiac event group ( LDL-cholesterol ; 16 % vs 25 % , p = 0.04 ) . These results suggested the following ; 1 ) Pravastatin maintained a cholesterol lowering effect long-term without serious complications . 2 ) Pravastatin administration might reduce the mortality rate and myocardial infa rct ion . 3 ) The combination of multiple risks is a strong factor for a cardiac event in addition to hypercholesterolemia
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 .