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 .
Diet and pravastatin in moderate hypercholesterolaemia: a randomized trial in 215 middle-aged men free from cardiovascular disease.
OBJECTIVE To evaluate the effect of diet and drug intervention separately and combined in the treatment of primary hypercholesterolemia . DESIGN The study was conducted as a r and omized , placebo-controlled factorial trial , double-blinded for drug intervention . SETTING Subjects were recruited from a population -based cholesterol screening programme . SUBJECTS 215 middle-aged men with primary hypercholesterolemia , free from cardiovascular disease . INTERVENTIONS Subjects were r and omized to one of four intervention groups : ( 1 ) placebo and US National Cholesterol Education Program step 1 diet ; ( 2 ) placebo and step 2 diet ; ( 3 ) pravastatin 20 mg day-1 and step 1 diet ; or ( 4 ) pravastatin 20 mg day-1 and step 2 diet . The intervention period was 6 months . MAIN OUTCOME MEASUREMENTS Efficacy measurements included : serum total cholesterol , HDL cholesterol , triglycerides , apolipoproteins A1 and B. LDL cholesterol was calculated . For safety , values of ALAT , ASAT and CK were measured . RESULTS In the group receiving the step 1 diet only , lipid values were stable during the study period . In the placebo group on the step 2 diet , total cholesterol decreased by 6.3 % ( 0.47 mmol L-1 ( 95 % CI : 0.28 , 0.67 ) ) during 6 months . In the group receiving both pravastatin and the step 1 diet , there was a mean reduction in serum total cholesterol of 19.4 % ( 1.46 mmol L-1 ( 95 % CI : 1.20 , 1.72 ) ) . In the group treated with pravastatin and the step 2 diet , the 6 months of data show a reduction of 20.7 % ( 1.55 mmol L-1 ( 95 % CI : 1.30 , 1.80 ) ) . CONCLUSIONS If drug therapy with a HMG-CoA reductase inhibitor is considered necessary , a step 2 diet has no additional lipid-lowering effect compared with a step 1 diet in men with primary hypercholesterolaemia . However , favourable ' side-effects ' of a lipid-lowering diet , such as weight loss and lowering of blood pressure , may still warrant a low-fat diet in these cases
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 .