The Expected 30-Year Benefits of Early Versus Delayed Primary Prevention of Cardiovascular Disease by Lipid Lowering

Study employing 2 models (n=3148) suggests big reduction in expected atherosclerotic CVD risk in next 30 years achievable by intensive lipid lowering (LL) in individuals in 40s and 50s with non–HDL-C ≥4.14 mmol/L, but question for many, is when to rather than whether to start LL.

SPS commentary:

According to an editorial, some uncertainties regarding statin use in primary prevention of atherosclerotic CVD will be clarified in the years to come, and some will never be removed. It suggest these data are an important step in restructuring the collective thinking regarding cholesterol management in primary prevention and the long-term benefit approach should be the basis of future guidance concerning in whom preventive treatment should be targeted, and when. It notes this may increase statin use among young individuals with great expected long-term benefits, but may also decrease statin use among elderly patients with competing non-CV risks, though the long-term benefit approach should enhance discussions with patients regarding “if” and “when” to start taking a statin.

Circulation