How effective are statins in the primary prevention of cardiovascular disease (CVD) in people at low risk?
Selective reporting of outcomes, adverse events and inclusion of people with cardiovascular disease in many of the trials included in previous reviews of the role of statins in primary prevention make the evidence impossible to disentangle without individual patient data. Caution also needs to be taken regarding the fact that all but 1 of the trials had some form of pharmaceutical industry sponsorship. Overall, the populations sampled within this review were white, male and middle-aged. Therefore, caution needs to be taken regarding generalisability to older people who may be at greater risk of side effects, and to women who are at lower risk of CVD events.
CVD is ranked as the number 1 cause of mortality and a major cause of morbidity worldwide. Previous reviews of the effects of statins have highlighted their benefits in people with CVD. The case for primary prevention, however, is less clear.