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 .
Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations.
OBJECTIVE --To examine the relation between serum cholesterol concentration and mortality ( from coronary heart disease and from other causes ) below the range of cholesterol values generally seen in Western population s. DESIGN -- Prospect i ve observational study based on 8 - 13 years of follow up of subjects in a population with low cholesterol concentrations . SETTING --Urban Shanghai , China . SUBJECTS--9021 Chinese men and women aged 35 - 64 at baseline . MAIN OUTCOME MEASURE -- Death from coronary heart disease and other causes . RESULTS --The average serum cholesterol concentration was 4.2 mmol/l at baseline examination , and only 43 ( 7 % ) of the deaths that occurred during 8 - 13 years of follow up were attributed to coronary heart disease . There was a strongly positive , and apparently independent , relation between serum cholesterol concentration and death from coronary heart disease ( z = 3.47 , p less than 0.001 ) , and within the range of usual serum cholesterol concentration studied ( 3.8 - 4.7 mmol/l ) there was no evidence of any threshold . After appropriate adjustment for the regression dilution bias , a 4 ( SD 1)% difference in usual cholesterol concentration was associated with a 21 ( SD 6)% ( 95 % confidence interval 9 % to 35 % ) difference in mortality from coronary heart disease . There was no significant relation between serum cholesterol concentration and death from stroke or all types of cancer . The 79 deaths due to liver cancer or other chronic liver disease were inversely related to cholesterol concentration at baseline . CONCLUSION --Blood cholesterol concentration was directly related to mortality from coronary heart disease even in those with what was , by Western st and ards , a " low " cholesterol concentration . There was no good evidence of an adverse effect of cholesterol on other causes of death
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 .