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 .
Tracking of high-sensitivity C-reactive protein after an initially elevated concentration: the JUPITER Study.
BACKGROUND The JUPITER ( Justification for the Use of Statins in Prevention : An Intervention Trial Evaluating Rosuvastatin ) trial suggests that increased high-sensitivity C-reactive protein ( hsCRP ) concentrations may be useful in decisions about the initiation of statin therapy for primary prevention of vascular disease . Although studies of specific population s have suggested that hsCRP is a reliable longitudinal marker , it is unclear how strongly hsCRP tracks in individuals after a single increased concentration . METHODS We evaluated tracking of hsCRP in 8901 individuals r and omized to placebo in the JUPITER trial . These individuals had screening LDL cholesterol concentrations < 130 mg/dL ( < 3.37 mmol/L ) and hsCRP concentrations > or = 2 mg/L , with subsequent hsCRP measurements made before r and omization ; at 13 weeks ; 1 , 2 , 3 , and 4 years later ; and at trial termination . Longitudinal trends and associations were evaluated nonparametrically with box plots and Spearman correlations . After data transformation to achieve normality , repeated- measures regression models estimated the intraclass correlation of hsCRP , with and without controlling for known demographic , lifestyle , and medical determinants of hsCRP concentration . For comparison , we evaluated tracking of systolic and diastolic blood pressure ; total , LDL , and HDL cholesterol ; and fasting triglycerides . RESULTS The median hsCRP concentration in these untreated individuals showed modest regression to the mean over time , declining from 3.8 mg/L at r and omization to 3.4 mg/L at 4 years . Tracking correlations for hsCRP over time were comparable to those for blood pressure and LDL cholesterol , but lower than those for HDL , fasting triglycerides , and total cholesterol . The intraclass correlation for repeated hsCRP measurements was 0.54 ( 95 % CI , 0.53 - 0.55 ) without covariate adjustment and 0.50 ( 95 % CI , 0.49 - 0.51 ) after adjustment for demographic , lifestyle , and comorbidity determinants . CONCLUSIONS Concentrations of hsCRP show strong tracking , even after selection of individuals with initially high values . Without statin therapy , increased concentrations of hsCRP generally remain high over time
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 .