Statins for Primary Prevention of Cardiovascular Disease: Review of Evidence and Recommendations for Clinical Practice

Dhruv S Kazi; Joanne M Penko; Kirsten Bibbins-Domingo

doi:10.1016/j.mcna.2017.03.001

Statins for Primary Prevention of Cardiovascular Disease: Review of Evidence and Recommendations for Clinical Practice

Med Clin North Am. 2017 Jul;101(4):689-699. doi: 10.1016/j.mcna.2017.03.001.

Authors

Dhruv S Kazi¹, Joanne M Penko², Kirsten Bibbins-Domingo³

Affiliations

¹ Department of Medicine, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94122, USA; Department of Epidemiology, University of California San Francisco, 550 16th Street, San Francisco, CA 94158, USA; UCSF Center for Vulnerable Populations, 2789 25th Street, Suite 350, San Francisco, CA 94110, USA; UCSF Center for Healthcare Value, 3333 California Street, Suite 265, San Francisco, CA 94118, USA; Division of Cardiology, Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
² UCSF Center for Vulnerable Populations, 2789 25th Street, Suite 350, San Francisco, CA 94110, USA; Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, UCSF Box 1364, San Francisco, CA 94143-1364, USA.
³ Department of Medicine, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94122, USA; Department of Epidemiology, University of California San Francisco, 550 16th Street, San Francisco, CA 94158, USA; UCSF Center for Vulnerable Populations, 2789 25th Street, Suite 350, San Francisco, CA 94110, USA; Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, UCSF Box 1364, San Francisco, CA 94143-1364, USA. Electronic address: kirsten.bibbins-domingo@ucsf.edu.

PMID: 28577620
DOI: 10.1016/j.mcna.2017.03.001

Abstract

Numerous large randomized clinical trials have shown that statin therapy is effective and safe for primary prevention of atherosclerotic cardiovascular disease (CVD) for adults aged 40 to 75 years and support the use of 10-year CVD risk as a means to identify individuals for treatment. Uncertainty exists in those older than 75 years who may be more likely to benefit because of their underlying CVD risk, but also face uncertain harms. Several high-quality mathematical simulation models have shown that statin therapy is cost-effective for primary prevention of atherosclerotic CVD. Despite effectiveness and safety, statins are underutilized for primary prevention.

Keywords: 10-year risk; Cardiovascular disease; Cholesterol; Lipids; Statin; Statin intolerance.

Publication types

Review

MeSH terms

Age Factors
Atherosclerosis / prevention & control*
Cardiovascular Diseases / prevention & control
Cost-Benefit Analysis
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
Hydroxymethylglutaryl-CoA Reductase Inhibitors / economics
Life Style
Practice Guidelines as Topic
Primary Prevention / methods*
Randomized Controlled Trials as Topic
Risk Assessment

Substances

Hydroxymethylglutaryl-CoA Reductase Inhibitors