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 .
Pravastatin reduces carotid intima-media thickness progression in an asymptomatic hypercholesterolemic mediterranean population: the Carotid Atherosclerosis Italian Ultrasound Study.
PURPOSE The Carotid Atherosclerosis Italian Ultrasound Study ( CAIUS ) was performed to test the effects of lipid lowering on the progression of carotid intima-media thickness ( IMT ) in 305 asymptomatic patients from a Mediterranean country . PATIENTS AND METHODS Eligibility included hypercholesterolemia ( baseline means : low-density lipoprotein [ LDL ] = 4.68 mmol/L , high-density lipoprotein [ HDL ] = 1.37 mmol/L ) , and at least one 1.3 < IMT < 3.5 mm in the carotid arteries . Patients ( mean age 55 years , 53 % male ) were assigned to pravastatin ( 40 mg/day , n = 151 ) or placebo ( n not equal to 154 ) . Ultrasound imaging was used to quantify IMT at baseline , and semiannually thereafter for up to 3 years . The mean of the 12 maximum IMTs ( MMaxIMT ) , was calculated for each patient visit , and used to determine each patient 's longitudinal progression slope . The intention-to-treat group difference in the MMaxIMT progression was chosen a priori as the primary end point . RESULTS Five serious cardiovascular events ( 1 fatal myocardial infa rct ion ) , and 7 drop-outs for cancer were registered . In the pravastatin group , LDL decreased -0.22 after 3 months versus -0.01 in the placebo group , and remained substantially unchanged afterward ( -0.23 versus + 0.01 at 36 months , respectively ) . Progression of the MMaxIMT was 0.009 + /- 0.0027 versus -0.0043 + /- 0.0028 mm/year ( mean + /- SE , P < 0.0007 ) in the placebo and pravastatin groups , respectively . IMT progression slopes diverged after 6 months of treatment . CONCLUSIONS Pravastatin stops the progression of carotid IMT in asymptomatic , moderately hypercholesterolemic men and women . This finding extends the beneficial effects of cholesterol lowering to the primary prevention of atherosclerosis in a population with relatively low cardiovascular event rates , and suggests that this benefit is mediated by specific morphological effects on early stages of plaque development
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 .