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 results: two-year efficacy and safety follow-up.
The Exp and ed Clinical Evaluation of Lovastatin study , a r and omized , double-blind , placebo- and diet-controlled multicenter trial , evaluated the efficacy and tolerability of lovastatin over 48 weeks in 8,245 patients with moderately severe hypercholesterolemia . During year 1 of follow-up of the full cohort , lovastatin at 20 or 40 mg/day , or 20 or 40 mg twice daily , produced dose-dependent decreases in low-density lipoprotein ( LDL ) cholesterol ( 24 % to 40 % ) and triglyceride levels ( 10 % to 19 % ) , and increases in high-density lipoprotein ( HDL ) cholesterol ( 6.6 % to 9.5 % ) . In all , 977 patients continued their original blinded treatment for an additional year . In year 2 , the LDL cholesterol response to lovastatin was maintained , the triglyceride reductions were somewhat less , and the increases in HDL cholesterol were moderately greater than in year 1 . Successive transaminase elevations > 3 times the upper limit of normal were observed in only 1 patient in year 2 , yielding a cumulative 2-year incidence of from 0.1 % ( placebo or lovastatin 20 mg/day ) to 1.9 % ( lovastatin 80 mg/day ) . Myopathy occurred in only 1 patient during year 2 , and over the 2-year study was observed rarely and only at lovastatin dosages of 40 and 80 mg/day . This study indicates that lovastatin maintains its efficacy over long-term follow-up , particularly in effectively lowering LDL cholesterol , is generally well tolerated , and has a favorable safety profile
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 .