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 .
Statins for Asymptomatic Middle Cerebral Artery Stenosis: The Regression of Cerebral Artery Stenosis Study
Background : The progression of cerebral atherosclerosis increases the risk of stroke and vascular events . Given the known benefits of statins in retarding coronary and carotid atherosclerosis progression , we studied the effects of statins on asymptomatic middle cerebral artery ( MCA ) stenosis progression . Methods : We conducted a r and omized , double-blind , placebo-controlled study to evaluate the effects of simvastatin on the progression of MCA stenosis among stroke-free individuals who had mild to moderately elevated LDL cholesterol ( 3.0–5.0 mmol/l ) . Two hundred and twenty-seven subjects were r and omized to either placebo ( n = 114 ) or simvastatin 20 mg daily ( n = 113 ) . The severity of MCA stenosis at baseline and at the end of the study was grade d by MRA into normal , minimal ( < 10 % ) , mild ( 10–49 % ) , moderate ( 50–90 % ) and severe ( > 90 % ) . The primary outcome was the change in grading of MCA stenosis over 2 years . Results : At the end of the study , the LDL cholesterol level decreased by 1.43 and 0.12 mmol/l for the active and placebo groups , respectively ( p < 0.001 ) . There was no significant difference in the proportion of patients having stable , progressive and regressive MCA stenosis between the placebo ( 72 , 22 and 6 % ) and active groups ( 78.6 , 15.5 and 5.8 % ) . The all-cause mortality was significantly lower in the active group ( n = 0 ) relative to the placebo group ( n = 7 , p = 0.014 ) . Any clinical events were also lower in the active group ( n = 5 ) than in the placebo group ( n = 13 , p = 0.052 ) . Conclusions : Simvastatin 20 mg daily had no apparent effect upon the evolution of asymptomatic MCA stenosis over 2 years
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 .