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 .
Long-term effects of pravastatin and fosinopril on peripheral endothelial function in albuminuric subjects.
The purpose of this double-blind , r and omized , placebo-controlled trial was to determine the long-term effects of pravastatin and fosinopril treatment on peripheral endothelial function in subjects with albuminuria . Subjects ( mean age 51 years , 63 % male ) were r and omized to pravastatin 40 mg or matching placebo and  to  fosinopril 20 mg or matching placebo . Using high resolution ultrasound , flow-mediated dilation ( FMD ) and nitroglycerin-induced dilation ( NID ) was assessed at baseline and after 4 years of treatment in a total of 276 subjects . At baseline , mean+/-st and ard error FMD was 4.73+/-0.49 % and NID was 10.86+/-0.67 % . Pravastatin significantly reduced total cholesterol and LDL cholesterol ( p<0.01 ) and r and omization to pravastatin was associated with a non-significant improvement of 18.9 % in FMD ( + 0.80+/-0.95 , p=0.09 ) , without a significant change in NID . Interestingly , pravastatin significantly increased FMD by 34.9 % in men ( + 1.23 , p=0.04 ) , but only 1.1 % in women ( + 0.06 , p=0.95 ) . Fosinopril was not associated with a change in FMD or NID despite significantly decreasing urinary albumin excretion , systolic and diastolic blood pressure ( all p<0.01 ) . In conclusion , after 4 years of follow-up , pravastatin treatment tended to increase FMD and this effect was predominantly present in men . Fosinopril treatment did not modify FMD during long-term follow-up
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 .