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 atorvastatin on kidney outcomes and cardiovascular disease in patients with diabetes: an analysis from the Collaborative Atorvastatin Diabetes Study (CARDS).
BACKGROUND We examined whether atorvastatin affects diabetic kidney disease and whether the effect of atorvastatin on cardiovascular disease ( CVD ) varies by kidney status in patients with diabetes . STUDY DESIGN The Collaborative Atorvastatin Diabetes Study ( CARDS ) r and omized placebo-controlled trial . SETTING & PARTICIPANTS Patients with type 2 diabetes and no prior CVD ( n = 2,838 ) . INTERVENTION R and om allocation to atorvastatin , 10 mg/d , or placebo , with a median follow-up of 3.9 years . OUTCOMES Estimated glomerular filtration rate ( eGFR ) , albuminuria , CVD . MEASUREMENTS Baseline and follow-up GFRs were estimated by using the Modification of Diet in Renal Disease Study equation . Urinary albumin-creatinine ratio was measured on spot urine sample s. RESULTS At baseline , 34 % of patients had an eGFR of 30 to 60 mL/min/1.73 m(2 ) . Atorvastatin treatment was associated with a modest improvement in annual change in eGFR ( net , 0.18 mL/min/1.73 m(2)/y ; 95 % confidence interval [ CI ] , 0.04 to 0.32 ; P = 0.01 ) that was most apparent in those with albuminuria ( net improvement , 0.38 mL/min/1.73 m(2)/y ; P = 0.03 ) . At baseline , 21.5 % of patients had albuminuria and an additional 6.8 % developed albuminuria during follow-up . Atorvastatin did not influence the incidence of albuminuria ( hazard ratio , 1.49 ; 95 % CI , 0.73 to 3.04 ; P = 0.3 ) or regression to normoalbuminuria ( hazard ratio , 1.19 ; 95 % CI , 0.57 to 2.49 ; P = 0.6 ) . In 970 patients with a moderately decreased eGFR of 30 to 60 mL/min/1.73 m(2 ) , there was a 42 % reduction in major CVD events with treatment , including a 61 % reduction in stroke . This treatment effect was similar to the 37 % ( 95 % CI , 17 to 52 ; P < 0.001 ) reduction in CVD observed in the study overall ( P = 0.4 for the eGFR-treatment interaction ) . LIMITATIONS Low incidence rates of albuminuria and transition to more severe kidney status limit power to detect treatment effects . CONCLUSIONS A modest beneficial effect of atorvastatin on eGFR , particularly in those with albuminuria , was observed . Atorvastatin did not influence albuminuria incidence .  Atorvastatin was effective at decreasing CVD in those with and without a moderately decreased eGFR and achieved a high absolute benefit
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 .