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 .
Rosuvastatin for Primary Prevention in Older Persons With Elevated C-Reactive Protein and Low to Average Low-Density Lipoprotein Cholesterol Levels: Exploratory Analysis of a Randomized Trial
BACKGROUND R and omized data on statins for primary prevention in older persons are limited , and the relative hazard of cardiovascular disease associated with an elevated cholesterol level weakens with advancing age . OBJECTIVE To assess the efficacy and safety of rosuvastatin in persons 70 years or older . DESIGN Secondary analysis of JUPITER ( Justification for the Use of statins in Prevention : an Intervention Trial Evaluating Rosuvastatin ) , a r and omized , double-blind , placebo-controlled trial . SETTING 1315 sites in 26 countries r and omly assigned participants in JUPITER . PARTICIPANTS Among the 17 802 participants r and omly assigned with low-density lipoprotein ( LDL ) cholesterol levels less than 3.37 mmol/L ( < 130 mg/dL ) and high-sensitivity C-reactive protein levels of 2.0 mg/L or more without cardiovascular disease , 5695 were 70 years or older . INTERVENTION Participants were r and omly assigned in a 1:1 ratio to receive 20 mg of rosuvastatin daily or placebo . MEASUREMENTS The primary end point was the occurrence of a first cardiovascular event ( myocardial infa rct ion , stroke , arterial revascularization , hospitalization for unstable angina , or death from cardiovascular causes ) . RESULTS The 32 % of trial participants 70 years or older accrued 49 % ( n = 194 ) of the 393 confirmed primary end points . The rates of the primary end point in this age group were 1.22 and 1.99 per 100 person-years of follow-up in the rosuvastatin and placebo groups , respectively ( hazard ratio , 0.61 [ 95 % CI , 0.46 to 0.82 ] ; P < 0.001 ) . Corresponding rates of all-cause mortality in this age group were 1.63 and 2.04 ( hazard ratio , 0.80 [ CI , 0.62 to 1.04 ] ; P = 0.090 ) . Although no significant heterogeneity was found in treatment effects by age , absolute reductions in event rates associated with rosuvastatin were greater in older persons . The relative rate of any serious adverse event among older persons in the rosuvastatin versus placebo group was 1.05 ( CI , 0.93 to 1.17 ) . LIMITATION Effect estimates from this exploratory analysis with age cut-point chosen after trial completion should be viewed in the context of the overall trial results . CONCLUSION In apparently healthy older persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels , rosuvastatin reduces the incidence of major cardiovascular events . PRIMARY FUNDING SOURCE AstraZeneca
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 .