Using statins for primary prevention of cardiovascular disease is associated with a lower risk of death from any cause, serious vascular events and revascularizations when compared with a placebo, a Clinical Evidence Synopsis published online Dec. 11 in JAMA found.
The researchers, led by Fiona C. Taylor, PhD, of the London School of Hygiene and Tropical Medicine, analyzed18 randomized clinical trials with a total of 56,934 participants conducted between 1994 and 2008. They found that pravastatin (Pravachol, Bristol-Myers Squibb) was the most frequently used statin in the studies. They considered all the studies high quality and all were funded by drug manufacturers.
When compared with placebo, statins lowered low-density lipoprotein (LDL) cholesterol by 39 mg/dL. Statins were also associated with a lower all-cause mortality risk (relative risk [RR] 0.66), a lower risk of both fatal and nonfatal cardiovascular disease (RR 0.75), a lower risk of fatal and nonfatal coronary heart disease events (RR 0.73) and a lower risk of fatal and nonfatal stroke (RR 0.78).
American College of Cardiology/American Heart Association (ACC/AHA) guidelines have recommended moderate-to-high intensity statin therapy to lower the chances of cardiovascular disease in high-risk groups—people with LDL cholesterol levels of 190 or higher, adults ages 40 to 75 with diabetes and adults ages 40 to 75 with LDL cholesterol levels between 70 and 189 along with a 7.5 percent or higher estimated risk of atherosclerosis.
The authors additionally suggested using “moderate-dose statin treatment in individuals with an estimated 10-year risk of five percent to less than 7.5 percent (class IIa recommendation), though the level of evidence supporting this recommendation is graded as B by the ACC/AHA criteria and as weak by the National Institutes of Health criteria.”