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 .
Comparative efficacy study of atorvastatin vs simvastatin, pravastatin, lovastatin and placebo in type 2 diabetic patients with hypercholesterolaemia.
Although there is little information from primary or secondary prevention trials on cholesterol-lowering medication in diabetic patients , the reduction of elevated cholesterol is widely recommended for this group . The American Diabetes Association ( ADA ) recommends drug therapy in diabetic patients if low density lipoprotein (LDL)-cholesterol remains at > 130 mg/dl , or > 100 mg/dl in patients with macroangiopathy , after dietary intervention . When cholesterollowering medication is indicated , the choice of the drug must take into account the other lipid abnormalities that are often present and the need to maintain optimal glycaemic control . In the present study we compared the efficacy and safety of the novel HMG-CoA reductase inhibitor atorvastatin at the dose of 10 mg/day with simvastatin , lovastatin and pravastatin at doses of 10 , 20 and 20 mg/day , respectively , and placebo , in type 2 diabetic patients with moderate elevation of LDL-cholesterol with or without elevation of triglycerides .  All the quoted agents are enzyme inhibitors effective in lowering LDL-cholesterol in humans . The efficacy endpoints were the mean per cent changes in plasma LDL-cholesterol ( primary ) , total cholesterol , triglycerides , and high-density lipoprotein (HDL)-cholesterol concentrations from baseline to the end of treatment ( 24 weeks ) . Atorvastatin at a dose of 10 mg/day produced : ( 1 ) a significant reduction in LDL-cholesterol ( -37 % ) in comparison with equivalent doses of simvastatin ( -26 % ) , pravastatin ( -23 % ) , lovastatin ( -21 % ) , and placebo ( -1 % ) ; ( 2 ) HDL-cholesterol increases ( 7.4 % ) comparable to or greater than those obtained with simvastatin ( 7.1 % ) , pravastatin ( 3.2 % ) , lovastatin ( 7.21 % ) , and placebo ( -0.5 % ) ; ( 3 ) a significantly greater reduction in total cholesterol ( - 29 % ) than that obtained with simvastatin ( -21 % ) , pravastain ( -16 % ) , lovastatin ( -18 % ) , and placebo ( 1 % ) ; and ( 4 ) a significantly greater reduction in triglycerides than that obtained with all the other drugs and placebo . In all treatment groups no significant variation in fibrinogen concentration was observed . All reductase inhibitors studied had similar levels of tolerance . There were no incidents of persistent elevations of serum aminotransferases or myositis
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 .