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 .
Statin Cost-Effectiveness in the United States for People at Different Vascular Risk Levels
Background —Statins reduce the rates of heart attacks , strokes , and revascularization procedures ( ie , major vascular events ) in a wide range of circumstances . R and omized controlled trial data from 20 536 adults have been used to estimate the cost-effectiveness of prescribing statin therapy in the United States for people at different levels of vascular disease risk and to explore whether wider use of generic statins beyond the population s currently recommended for treatment in clinical guidelines is indicated . Methods and Results —R and omized controlled trial data , an internally vali date d vascular disease model , and US costs of statin therapy and other medical care were used to project lifetime risks of vascular events and evaluate the cost-effectiveness of 40 mg simvastatin daily . For an average of 5 years , allocation to simvastatin reduced the estimated US costs of hospitalizations for vascular events by ≈20 % ( 95 % CI , 15 to 24 ) in the different subcategories of participants studied . At a daily cost of $ 1 for 40 mg generic simvastatin , the estimated costs of preventing a vascular death within the 5-year study period ranged from a net saving of $ 1300 ( 95 % CI , $ 15 600 saving to $ 13 200 cost ) among participants with a 42 % 5-year major vascular event risk to a net cost of $ 216 500 ( $ 123 700 to $ 460 000 cost ) among those with a 12 % 5-year risk . The costs per life year gained with lifetime simvastatin treatment ranged from $ 2500 ( −$40 to $ 3820 ) in people aged 40 to 49 years with a 42 % 5-year major vascular event risk to $ 10 990 ( $ 9430 to $ 14 700 ) in people aged 70 years and older with a 12 % 5-year risk . Conclusions —Treatment with generic simvastatin appears to be cost-effective for a much wider population in the United States than that recommended by current guidelines
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 .