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 .
Long-term safety and efficacy profile of simvastatin.
Simvastatin , a 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor , has been administered to approximately 2,400 patients with primary hypercholesterolemia with a mean follow-up of 1 year in controlled clinical studies and their open extensions . Approximately 10 % of this population received simvastatin for a period of greater than or equal to 2 years . The population on whom this safety analysis is based had a mean age of 50 years ; 62 % were men and approximately 27 % had preexisting coronary artery disease .  Simvastatin was titrated to the maximal daily dose of 40 mg each evening in 56 % of the study population ( last recorded dose ) . The most frequently reported drug-related clinical adverse experiences were constipation ( 2.5 % ) , abdominal pain ( 2.2 % ) , flatulence ( 2.0 % ) and headaches ( 1 % ) . Persistent elevations of serum transaminase levels greater than 3 times the upper limit of normal were observed in only 1 % of this cohort with only 0.1 % of the total population requiring discontinuation of therapy . There were no clinical ly apparent episodes of hepatitis . Discontinuation of therapy due to myopathy was extremely rare ( 0.08 % ) . Only minimal increases in the frequency of lens opacities ( 1 % ) were observed from baseline to the last lens examination during follow-up , consistent with the expected increase in lens opacity development due to normal aging . Patients who were greater than or equal to 65 years old had a clinical and laboratory safety profile comparable to the nonelderly population . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .