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 .
Compliance with and efficacy of treatment with pravastatin and cholestyramine: a randomized study on lipid-lowering in primary care.
OBJECTIVES Lipid-lowering drugs as 3-hydroxy-3-methyl glutaryl coenzyme A ( HMG-CoA ) reductase inhibitors and cholestyramine are effective in reducing cardiovascular morbidity both in primary and secondary prevention . Patient compliance is an important determinant of the outcome of therapy . This study was design ed to compare compliance with tolerance and lipid-lowering effectiveness of pravastatin and /or cholestyramine in primary care . DESIGN Nine hundred and eighty nine women and 1047 men were r and omized to treatment at 100 primary -care centres in Sweden . After dietary intervention , an eligible patient was r and omly assigned to one of four programs of daily treatment : group Q , 16 g cholestyramine , group QP , 8 g cholestyramine and 20 mg pravastatin , group P20 , 20 mg pravastatin or group P40 , 40 mg pravastatin . RESULTS In group Q , group QP , group P20 and group P40 the reductions in low density lipoprotein (LDL)-cholesterol were 26 % , 36 % , 27 % and 32 % . The dose actually taken was 91 - 95 % of the prescribed for the pravastatin treatment groups and 77 - 88 % for the cholestyramine groups . In the pravastatin and cholestyramine groups 76 - 78 % and 44 - 53 % , respectively , completed the trial . Only 8 - 27 % of the patients reached a serum cholesterol target level of 5.2 mmol L-1 . There was no difference in lipid-lowering effect between women and men . CONCLUSION Pravastatin alone is efficacious and compliance is high , independent of dose . Combined treatment with cholestyramine and pravastatin had a better cholesterol lowering effect ( although not statistically significant ) than 40 mg pravastatin . Despite this , only 8 - 27 % of the patients actually reached a serum cholesterol level of 5.2 mmol L-1 . No unexpected serious adverse events were detected in any of the treatment groups . As predicted , the gastrointestinal disturbances were more common on cholestyramine treatment . These two factors suggest that an increase in the dosage of the HMG-CoA reductase inhibitor may be appropriate . Results from other studies indicate that there also might be other positive effects of statin treatment beyond cholesterol lowering
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 .