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 .
Randomised placebo controlled trial of effect on mood of lowering cholesterol concentration
Abstract Objective : To evaluate the effects on mood of a substantial and prolonged reduction in total cholesterol concentration . Design : R and omised placebo controlled comparison of patients who had been allocated to receive simvastatin 20 mg or 40 mg daily versus those allocated matching placebo  in a ratio of 2:1 . Follow up at an average of 152 weeks after r and omisation . Subjects : Men and women aged between 40 and 75 years at entry with blood total cholesterol of 3.5 mmol/l or greater , who were considered to be at higher than average risk of coronary heart disease based on medical history . Main outcome measures : The shortened profile of mood states question naire , reported use of psychotropic medication , and symptoms possibly related to mood . Results : Simvastatin reduced total cholesterol by 1.9 mmol/l ( 26.7 % ) at the time of follow up . Among all 621 patients r and omised to simvastatin ( 414 patients ) or placebo ( 207 patients ) there were no significant differences in the use of psychotropic medication or in reports of symptoms possibly related to mood . Of these patients , 491 ( 334 simvastatin , 157 placebo ) completed the mood question naire , and there were no significant differences between the treatment groups in total or subscale scores , even when patients with low baseline cholesterol concentrations or elderly subjects were considered separately . Conclusion : These results do not support the hypothesis that treatment to lower cholesterol concentration causes mood disturbance . Key messages A r and omised placebo controlled trial of simvas- tatin ( a drug that lowers cholesterol concentration substantially ) showed no associated mood distur- bance over a period of nearly three years in subjects with cardiovascular disease and no pre-existing psychiatric conditions No effects on mood were seen in individuals with low baseline cholesterol concentrations or in older individuals , and there were no differences in use of psychotropic drugs between the treatment groups These results give little support to the idea that reducing cholesterol concentration has adverse effects on
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 .