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 .
Analysis of Efficacy and Safety in Patients Aged 65–75 Years at Randomization
OBJECTIVE —Rates of cardiovascular disease are highest in the elderly .  Lipid-lowering statin therapy reduces the proportional risk as effectively in older patients as in younger individuals ; however , limited data are available for elderly patients with type 2 diabetes . We conducted a post hoc analysis to compare the efficacy and safety of atorvastatin among 1,129 patients aged 65–75 years at r and omization with 1,709 younger patients in the Collaborative Atorvastatin Diabetes Study ( CARDS ) . RESEARCH DESIGN AND METHODS —CARDS was a r and omized  placebo-controlled trial of 10 mg/day atorvastatin for primary prevention of cardiovascular disease in patients aged 40–75 years with LDL cholesterol concentrations ≤4.14 mmol/l followed for a median of 3.9 years . The primary end point was time to first occurrence of acute coronary heart disease events , coronary revascularizations , or stroke . RESULTS —Atorvastatin treatment result ed in a 38 % reduction in relative risk ( [ 95 % CI −58 to −8 ] , P = 0.017 ) of first major cardiovascular events in older patients and a 37 % reduction ( [ −57 to −7 ] , P = 0.019 ) in younger patients . Corresponding absolute risk reductions were 3.9 and 2.7 % , respectively ( difference 1.2 % [ 95 % CI −2.8 to 5.3 ] , P = 0.546 ) ; numbers needed to treat for 4 years to avoid one event were 21 and 33 , respectively . All-cause mortality was reduced nonsignificantly by 22 % ( [ −49 to 18 ] , P = 0.245 ) and 37 % ( [ −64 to 9 ] , P = 0.98 ) , respectively . The overall safety profile of atorvastatin was similar between age-groups . CONCLUSIONS —Absolute and relative benefits of statin therapy in older patients with type 2 diabetes are substantial , and all patients warrant treatment unless specifically contraindicated
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 .