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 .
Effects of bezafibrate and of 2 HMG-CoA reductase inhibitors on lipoprotein (a) level in hypercholesterolemic patients.
Lp(a ) level is relatively stable in each individual and is mainly under genetic control . Attempts made to lower Lp(a ) with pharmacological means gave conflicting results . In order to further evaluate the effect of hypocholesterolemic drugs on Lp(a ) level , 66 patients with primary hypercholesterolemia were selected . The vast majority of the patients had Lp(a ) concentration at the low end of the range of distribution , 7 had undetectable Lp(a ) levels and only 2 had Lp(a ) higher than 30 mg/dl . No relationship was found between Lp(a ) level and serum and lipoprotein lipids . In 12 patients serum cholesterol was well controlled by diet alone and the patients continued the diet for up to 8 months . The other patients were r and omly subdivided into 3 groups of therapy . The first group received slow release bezafibrate 400 mg once a day , the second one pravastatin 20 mg once a day and the third one simvastatin 10 - 40 mg once a day . Drug therapy lasted for 8 months . At the end of the period , 22 of 29 patients treated with the 2 HMG-CoA reductase inhibitors had Lp(a ) higher than baseline . The difference was statistically significant in both groups of patients . No significant change in Lp(a ) was observed in diet and in bezafibrate group . Serum and LDL cholesterol significantly decreased in all the 3 drug groups . The increase in Lp(a ) after the 2 HMG-CoA reductase was small enough to have negligible effects on cardiovascular risk , but raises the problem of the role of LDL receptor in the catabolism of Lp(a )
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 .