Statins for Prevention of Cardiovascular Disease in Adults

This meta-analysis of 19 RCTs (n=71,344) with 0.5-6yrs of follow-up reports statin therapy was associated with reduced risk of clinical outcomes (all-cause mortality, CVD-related morbidity or mortality) vs placebo in adults at increased CV risk but without prior CV events.

Force (USPSTF) guidance, which recommends initiating use of low- to moderate-dose statins in adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors (dyslipidaemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of 10% or greater. The USPSTF also recommends that clinicians selectively offer low- to moderate-dose statins to adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors and a calculated 10-year CVD event risk of 7.5% to 10%. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of initiating statin use in adults 76 years and older.

 

NICE guidance on lipid modification for the prevention of cardiovascular disease recommends atorvastatin 20 mg for the primary prevention of CVD to people who have a 10% or greater 10 year risk of developing CVD (estimated with QRISK2). 

 

Atorvastatin 20 mg is also recommended for the primary prevention of CVD to people with type 1 diabetes who are over 40 years, have had diabetes for more than 10 years, have established nephropathy, or have other CVD risk factors, and also for those with chronic kidney disease. For patients with type 2 diabetes, atorvastatin 20 mg is recommended in those who have a 10% or greater 10 year risk of developing CVD (estimated with QRISK2).