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 .
Baseline risk factors and their association with outcome in the West of Scotland Coronary Prevention Study. The West of Scotland Coronary Prevention Study Group.
The West of Scotl and Coronary Prevention Study recently demonstrated the benefits of pravastatin therapy in the prevention of coronary heart disease events in middle-aged hypercholesterolemic men without prior myocardial infa rct ion . We present an analysis of the influence of baseline risk factors on coronary events and total mortality in the trial , and their interaction with therapy , using the Cox proportional hazards model . The multivariate predictors of fatal or nonfatal coronary events were treatment allocation ( pravastatin or placebo ) , current smoking , diabetes mellitus , nitrate consumption , minor electrocardiographic abnormalities , angina pectoris , family history of premature coronary death , widowhood , blood pressure , and total cholesterol/high density lipoprotein cholesterol ratio . Independent of other risk factors , pravastatin reduced the risk of definite coronary heart disease death or nonfatal myocardial infa rct ion by 32 % ( 95 % confidence interval 17 to 44 , p = 0.0001 ) , definite or suspected coronary heart disease death by 35 % ( 3 to 56 , p = 0.035 ) , cardiovascular death by 33 % ( 4 to 53 , p = 0.027 ) , coronary revascularization procedures by 38 % ( 11 to 56 , p = 0.009 ) , and all-cause mortality by 24 % ( 2 to 41 , p = 0.037 ) . The 5-year risk of fatal or nonfatal myocardial infa rct ion , calculated using the predictors identified in the Cox analysis , ranged from < 4.4 % in the lowest quartile of risk to > 9.6 % in the highest quartile . The proportional benefit achieved by pravastatin was independent of other risk factors ; hence , the absolute benefit of therapy was greatest in subjects with the highest baseline risk . Such subjects can be identified easily in the population and deserve high priority for treatment
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 .