Statins and Primary Prevention for Patients at High Risk for Heart Disease

Statins — which clearly confer an all-cause mortality benefit in patients with known cardiovascular disease (CVD) — are prescribed extensively for primary prevention in patients at high CVD risk but without CVD. Two groups of investigators examined evidence for this practice.

European investigators combined results for only high-risk patients without known CVD from 11 randomized controlled trials, including some previously unpublished data from the original investigators, to assess all-cause mortality in 65,000 patients (age range, 51–75). During average follow-up of nearly 4 years, the mean LDL cholesterol level was 134 mg/dL in placebo recipients and 94 mg/dL in statin recipients. Nearly 2800 deaths occurred, with about 100 fewer deaths in…