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 .
Expanded clinical evaluation of lovastatin (EXCEL) study: design and patient characteristics of a double-blind, placebo-controlled study in patients with moderate hypercholesterolemia.
The r and omized , double-blind , placebo-controlled trial described in this report was undertaken to clarify the dose-response relation of lovastatin therapy to lipid-modifying efficacy ( lipid/lipoprotein modification ) and drug-related adverse events in a population with moderately elevated fasting plasma total cholesterol ( 240 to 300 mg/dl ) and low-density lipoprotein cholesterol ( greater than or equal to 160 mg/dl ) . Men or women ( postmenopausal or surgically sterile ) , aged 18 to 70 years , were entered into the trial with minimal exclusion criteria . After 4 to 6 weeks of an American Heart Association phase I diet or a more stringent diet , 8,245 patients from 362 sites were r and omized to 1 of 5 parallel diet and drug treatment groups : placebo ( n = 1,663 ) or lovastatin , 20 mg ( n = 1,642 ) and 40 mg ( n = 1,645 ) with the evening meal , and 20 mg ( n = 1,646 ) or 40 mg twice daily ( n = 1,649 ) . The regimen of diet and lovastatin ( or placebo ) was followed for 48 weeks . The 5 treatment groups were similar at baseline . The total cohort had the following characteristics : 59 % were men ( mean age 56 years ) ; 92 % were white ; 59 % had completed at least 1 year of education beyond high school ; 57 % had a history of cardiovascular and associated disease ; 40 % had a history of hypertension ; and 29 % had coronary artery disease .  Health habits were similar among groups , with 18 % of patients reporting cigarette smoking , 14 % reporting that they consume greater than 1 alcoholic beverage daily and 67 % reporting no strenous exercise . Mean lipid/lipoprotein levels were also similar among groups , with the following average levels : total cholesterol ( 258 mg/dl ) , low-density lipoprotein cholesterol ( 180 mg/dl ) , high-density lipoprotein cholesterol ( 45 mg/dl ) and triglycerides ( median = 155 mg/dl ) . The large size of this trial , its placebo-controlled , double-blind design and the similarity of treatment groups at baseline should allow clear documentation of the long-term effects of lovastatin treatment and generalization of the results to a substantial portion of patients who may be c and i date s for lipid-modifying therapy
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 .