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 .
Design of the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with type 2 diabetes.
BACKGROUND There are few data on the role of lipid lowering in the primary prevention of  coronary heart disease ( CHD ) in diabetic patients . This paper describes the design of a collaborative clinical trial between Diabetes UK , the NHS Research and Development Directorate and Pfizer UK , that addresses this question . METHODS The Collaborative AtoRvastatin Diabetes Study ( CARDS ) is a multicentre , r and omized , placebo-controlled , double-blind clinical trial of primary prevention of cardiovascular disease in patients with Type 2 diabetes . The primary objective is to investigate whether treatment with the hydroxymethylglutaryl coenzyme A reductase inhibitor , atorvastatin , reduces the incidence of major cardiovascular events . At entry patients have at least one other risk factor for CHD in addition to diabetes , namely current smoking , hypertension , retinopathy , or micro- or macroalbuminuria . At r and omization patients have been selected for a serum low-density lipoprotein ( LDL ) cholesterol concentration < or = 4.14 mmol/l ( 160 mg/dl ) and triglycerides < or = 6.78 mmol/l ( 600 mg/dl ) . R and omization was completed in June 2001 . Patients will be followed until 304 primary endpoints have accrued ( expected date early 2005 ) . The trial includes 2838 men and women aged 40 - 75 years . This report describes the design and administration of the study and review s the evidence to date of the effectiveness of  lipid-lowering therapy in Type 2 diabetes . CONCLUSIONS The case for lipid-lowering therapy for the primary prevention of CHD in diabetes has not been demonstrated . CARDS will provide essential information on the extent of any benefits and adverse effects of lipid-lowering therapy in diabetic patients without prior CHD
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 .