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Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

The efficacy and safety of pravastatin in patients aged 60 to 85 years with low-density lipoprotein cholesterol > 160 mg/dl.

This study demonstrated that pravastatin 20 mg once daily significantly lowered total cholesterol ( by 19 % ) and LDL cholesterol by 25 %

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Intima-media thickness after pravastatin stabilizes also in patients with moderate to no reduction in LDL-cholesterol levels: the carotid atherosclerosis Italian ultrasound study.

The Carotid Atherosclerosis Italian Ultrasound study ( CAIUS ) , a multicenter , double-blind clinical trial , performed in 305 asymptomatic , moderately hypercholesterolemic patients , clearly demonstrated beneficial effects of pravastatin on the carotid intima-media thickness ( IMT ) progression . The data base of the CAIUS study was examined in order to investigate the presence of a relationship , if any , between the activity of pravastatin on IMT progression rate and its hypocholesterolemic effect . Quantitative B-mode ultrasound imaging was used to quantify the individual mean maximum IMT progression rate in 3 years . In the overall group of patients ( placebo and pravastatin ) covariance analysis showed that while the variable ' treatment ' ( 0 = placebo , 1 = pravastatin ) was significantly related to the reduction of IMT progression ( F= 6.6 , P = 0.01 ) , the IMT progression did not correlate with the extent of LDL-C lowering ( F= 0.00 , P = 0.98 ) . To further investigate this issue . the pravastatin treated group was stratified into quartiles of LDL-C reduction . In contrast to what was observed in the placebo group , in which a positive mean IMT progression rate was observed , independent of the extent of LDL-C reduction , no IMT progressionwas observed in any subgroup treated with pravastatin . No significant difference was found among quartiles and no trend could be identified . In conclusion , the effect of pravastatin treatment on carotid IMT progression rate is beneficial ; however the CAIUS study demonstrated that lowering LDL-C by itself , does not explain the variability of beneficial changes in IMT

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Baseline characteristics of participants in the JUPITER trial, a randomized placebo-controlled primary prevention trial of statin therapy among individuals with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein.

The Justification for the Use of statins in Primary prevention : an Intervention Trial Evaluating Rosuvastatin ( JUPITER ) is a r and omized , double-blind , placebo-controlled primary prevention trial of statin therapy among persons with average to low levels of low-density lipoprotein ( LDL ) cholesterol who are at increased cardiovascular risk due to elevated plasma concentrations of the inflammatory biomarker high-sensitivity C-reactive protein ( hs-CRP ) . A total of 17,802 persons with LDL cholesterol<130 mg/dl ( 3.36 mmol/L ) and hs-CRP > or=2 mg/L were recruited from 26 countries and r and omly allocated to 20 mg/day rosuvastatin or placebo . In contrast to previous studies of statin therapy in primary prevention , JUPITER is evaluating a group with modest plasma concentrations of LDL cholesterol ( median 108 mg/dl , interquartile range 94 to 119 ) . Further , the trial includes 6,801 women ( 38.2 % ) and 5,577 participants with metabolic syndrome ( 32.1 % ) . Thus , in addition to broadening our underst and ing of statin therapy and inflammation , the JUPITER trial will provide important and clinical ly relevant information on primary prevention among patients who do not currently qualify for lipid-lowering therapy . In conclusion , as 20 mg of rosuvastatin can reduce LDL cholesterol by up to 50 % , JUPITER will also provide crucial safety data for several thous and patients who should achieve LDL cholesterol levels<50 mg/dl on a long-term basis

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Simvastatin therapy for hypercholesterolemic patients with nephrotic syndrome or significant proteinuria.

Experimental evidence suggests that lipid lowering therapy could slow the progression of renal disease in humans . We have conducted a double-blind , placebo controlled trial of the HMG CoA reductase inhibitor simvastatin in patients with the nephrotic syndrome or significant proteinuria ( > 1 g/day ) and hypercholesterolemia ( > or = 6.5 mmol/liter ) . Patients were placed on a lipid lowering diet for at least 10 weeks before r and omization . After a four-week placebo run-in , 30 adults were r and omized to simvastatin or placebo therapy ( 10 mg/day , increasing to 20 to 40 mg/day as required ) for 24 weeks . There were seven dropouts , none of whom were " definitely " related to drug therapy . Total and LDL cholesterol levels fell by a mean of 33 and 31 % , respectively , in simvastatin treated patients , compared with only 5 and 1 % in patients on placebo ( P < 0.001 , P = 0.002 , respectively ) . Apolipoprotein B100 levels fell by a mean of 31 % in the simvastatin group but rose 0.3 % in the placebo group ( P = 0.014 ) . There were no significant changes in HDL levels . There were no significant differences between the groups in their urine protein levels , their rise in plasma creatinine , or decline in plasma inulin clearance . Simvastatin is a safe , effective therapy for hypercholesterolemia in proteinuric states . A much larger trial is needed to show if potent lipid-lowering therapy slows progression of hypercholesterolemic proteinuric diseases

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Cholesterol lowering in the elderly. Results of the Cholesterol Reduction in Seniors Program (CRISP) pilot study.

BACKGROUND Total and lipoprotein cholesterol levels continue to be predictors of coronary heart disease risk in men and women over 65 years old . Cholesterol-lowering trials , however , while sometimes including such subjects , have not concentrated on this age group . The Cholesterol Reduction in Seniors Program was a five-center pilot study to assess feasibility of recruitment and efficacy of cholesterol lowering in this age group . METHODS The study was a r and omized , double-masked clinical trial with placebo , 20-mg lovastatin , and 40-mg lovastatin arms . Major efforts were made to recruit women and minorities . Participants were followed up for 1 year on a cholesterol-lowering diet plus placebo or study drug . End points were changes in blood lipid levels . Data on other blood chemistry values , as well as quality -of-life measures and coronary heart disease morbidity and mortality , were also collected . RESULTS Four hundred thirty-one subjects with low-density lipoprotein cholesterol levels greater than 4.1 and less than 5.7 mmol/L ( 159 and 221 mg/dL ) were r and omized , of whom 71 % were women and 21 % were African Americans ; the mean age was 71 years . In the 20- and 40-mg lovastatin groups , total cholesterol levels fell 17 % and 20 % ; low-density lipoprotein cholesterol levels fell 24 % and 28 % ; triglyceride levels fell 4.4 % and 9.9 % , respectively . High-density lipoprotein cholesterol levels rose 7.0 % and 9.0 % , respectively . No changes were observed in the placebo group . Gender , race , and age did not significantly affect responses . Coronary heart disease morbidity and mortality data were collected but not analyzed for this study . CONCLUSION Older subjects of both genders and a variety of racial and ethnic groups can be successfully recruited into a cholesterol-lowering trial . Lovastatin has effects similar to those reported in younger subjects in previous controlled trials . There is little advantage to the higher lovastatin daily dose . Side effects were remarkably low in all groups

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Carotid intima-media thickness in low-risk individuals with asymptomatic atherosclerosis: baseline data from the METEOR study*

ABSTRACT Objective : Carotid intima-media thickness ( CIMT ) is an index for changes in atherosclerosis burden and changes in CIMT may relate to clinical events . We present baseline data from the METEOR study , a r and omized , placebo-controlled trial evaluating the efficacy of rosuvastatin 40 mg on changes in CIMT . We set out to compare differences in CIMT between several subgroups of individuals . Design and methods : A total of 984 individuals aged 45–70 years ( men ) or 55–70 ( women ) were r and omized . Participants were required to have : maximum CIMT ≥ 1.2– < 3.5 mm ; 2 + risk factors and 10-year coronary heart disease ( CHD ) risk < 10 % , or < 2 CHD risk factors . Demographic characteristics were compared in two groups : USA versus Europe , and individuals with maximum CIMT < 2 mm versus those with CIMT ≥ 2 mm . Baseline data : Overall , mean age was 57 years and mean low-density lipoprotein cholesterol was 152 mg/dL ( 3.9 mmol/L ) . Body mass index ( BMI ) , triglyceride and high-sensitivity C-reactive protein levels were all higher in US individuals , whereas smoking , hypertension and high-density lipoprotein cholesterol levels were higher in Europeans . Mean CIMT levels were the same in both population s , and the percentage of individuals with ≥ 2 CHD risk factors was similar . Increased baseline CIMT ( > 2 mm ) was related to increasing age , male gender , smoking , hypertension and lipid levels . Conclusions : In this global trial , differences in baseline characteristics between participants from the USA and Europe are apparent . However , a strong association between CIMT and several cardiovascular risk factors was observed across the two continents . Trial registration : Clinical Trials.gov identifier : NCT00225589

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease. Atorvastatin versus Revascularization Treatment Investigators.

BACKGROUND Percutaneous coronary revascularization is widely used in improving symptoms and exercise performance in patients with ischemic heart disease and stable angina pectoris . In this study , we compared percutaneous coronary revascularization with lipid-lowering treatment for reducing the incidence of ischemic events . METHODS We studied 341 patients with stable coronary artery disease , relatively normal left ventricular function , asymptomatic or mild-to-moderate angina , and a serum level of low-density lipoprotein ( LDL ) cholesterol of at least 115 mg per deciliter ( 3.0 mmol per liter ) who were referred for percutaneous revascularization . We r and omly assigned the patients either to receive medical treatment with atorvastatin , at 80 mg per day ( 164 patients ) , or to undergo the recommended percutaneous revascularization procedure ( angioplasty ) followed by usual care , which could include lipid-lowering treatment ( 177 patients ) . The follow-up period was 18 months . RESULTS Twenty-two ( 13 percent ) of the patients who received aggressive lipid-lowering treatment with atorvastatin ( result ing in a 46 percent reduction in the mean serum LDL cholesterol level , to 77 mg per deciliter [ 2.0 mmol per liter ] ) had ischemic events , as compared with 37 ( 21 percent ) of the patients who underwent angioplasty ( who had an 18 percent reduction in the mean serum LDL cholesterol level , to 119 mg per deciliter [ 3.0 mmol per liter ] ) . The incidence of ischemic events was thus 36 percent lower in the atorvastatin group over an 18-month period ( P=0.048 , which was not statistically significant after adjustment for interim analyses ) . This reduction in events was due to a smaller number of angioplasty procedures , coronary-artery bypass operations , and hospitalizations for worsening angina . As compared with the patients who were treated with angioplasty and usual care , the patients who received atorvastatin had a significantly longer time to the first ischemic event ( P=0.03 ) . CONCLUSIONS In low-risk patients with stable coronary artery disease , aggressive lipid-lowering therapy is at least as effective as angioplasty and usual care in reducing the incidence of ischemic events

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Kuopio Atherosclerosis Prevention Study (KAPS). A population-based primary preventive trial of the effect of LDL lowering on atherosclerotic progression in carotid and femoral arteries.

BACKGROUND The atherosclerotic progression-reducing effect of LDL cholesterol ( LDL-C ) lowering has been established in subjects with severe atherosclerotic disease but not in persons with elevated LDL cholesterols without severe atherosclerosis . KAPS ( Kuopio Atherosclerosis Prevention Study ) is the first population -based trial in the primary prevention of carotid and femoral atherosclerosis . METHODS AND RESULTS The eligibility requirements were serum LDL-C > or = 4.0 mmol/L and total cholesterol < 7.5 mmol/L. Out of a geographically defined population , 447 men aged 44 to 65 years ( mean , 57 ) were r and omized to pravastatin ( 40 mg/d ) or placebo for 3 years . Less than 10 % of the subjects had prior myocardial infa rct ion . Thirty-nine men discontinued study medication ; however , efficacy data were available for 424 men . The primary outcome was the rate of carotid atherosclerotic progression , measured as the linear slope over annual ultrasound examinations in the average of the maximum carotid intima-media thickness ( IMT ) of the far wall of up to four arterial segments ( the right and left distal common carotid artery and the right and left carotid bulb ) . For the carotid arteries , at the overall mean baseline IMT of 1.66 mm , the rate of progression of carotid atherosclerosis was 45 % ( 95 % CI , 16 to 69 % ) less in the pravastatin ( 0.017 mm/y ) than the placebo ( 0.031 mm/y ) group ( P = .005 ) . In the common carotid artery there was a treatment effect of 66 % ( 95 % CI , 30 to 95 % ; pravastatin 0.010 mm/y ; placebo 0.029 mm/y ; P < .002 ) at the overall mean baseline IMT of 1.35 mm . A treatment effect of 30 % ( 95 % CI , -1 % to 54 % ) was found for the carotid bulb ( pravastatin , 0.028 ; placebo , 0.040 ; P = .056 ) at the overall mean baseline IMT of 2.0 mm . The treatment effect was larger in subjects with higher baseline IMT values , in smokers and in those with low plasma vitamin E levels . There was no significant treatment effect on atherosclerotic progression in the femoral arteries . CONCLUSIONS These data establish the antiatherogenic effect of LDL-C lowering by pravastatin in hypercholesterolemic men in a primary prevention setting and suggest a greater effect in smokers than in nonsmokers

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effects of fluvastatin on insulin resistance and cardiac morphology in hypertensive patients

Among hypertensive patients , cardiovascular disease morbidity is common , even in those who are adequately treated . New pharmacological strategies to mitigate the burden of arterial hypertension are needed . This 12-month , r and omized , double-blind placebo-controlled study investigated the effect of statin ( fluvastatin ) treatment on ambulatory blood pressure ( ABP ) , exercise blood pressure ( EBP ) , myocardial structure , endothelial function and insulin resistance in 50 hypertensive patients . At baseline , the groups were comparable in terms of demographic characteristics , ABP , EBP , endothelial function and homeostasis model assessment of insulin resistance ( HOMA-IR ) . At the end of the study , there was no difference between groups in terms of resting systolic blood pressure . However , maximum systolic EBP was lower in the treatment group than in the placebo group ( 175±18 vs 192±23 mm Hg , P<0.05 ) , as was left ventricular mass index ( LVMI ; 82±15 vs 100±23 , P<0.05 ) , and HOMA-IR index was lower after fluvastatin treatment ( 2.77±1.46 vs 3.33±1.73 , P<0.05 ) . Changes in lipid profile were not correlated with blood pressure , endothelial function , LVMI or HOMA-IR data . In hypertensive patients , fluvastatin can improve maximum systolic EBP , myocardial remodelling and insulin resistance , independently of lipid profile variations and endothelial function

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study.

BACKGROUND In several statin trials , vascular event rates for treatment groups begin to separate 1 year after commencement of treatment . For atherosclerosis progression , the temporal sequence of the effect has not been defined . We used data from the Measuring Effects on intima media Thickness : an Evaluation Of Rosuvastatin ( METEOR ) trial to determine the earliest time point at which significant differences in atherosclerosis progression rates could be detected after initiation of statin therapy . METHODS The METEOR trial was a double-blind , r and omized placebo-controlled trial that studied the effect of LDL-C lowering with 40 mg rosuvastatin on the rate of change of carotid intima media thickness ( CIMT ) measured by B-mode ultrasound amongst 984 low risk subjects . Ultrasound assessment s were made at baseline and every 6 months up to 2 years . RESULTS Rosuvastatin treatment was associated with a 49 % reduction in LDL-C-C , a 34 % reduction in total cholesterol , an 8.0 % increase in HDL-C and a 16 % reduction in triglycerides ( all P < 0.0001 compared with placebo ) . The difference in rate of mean maximum CIMT progression between the rosuvastatin and placebo groups ( based on near and far wall measurements from both left and right common carotid and internal carotid segments and carotid bifurcation ) was not statistically significant after 6 months ( 0.0023 mm year(-1 ) and 0.0106 mm year(-1 ) , respectively P = 0.34 ) . After 12 months , CIMT progression rates were significantly different between the groups : 0.0032 mm year(-1 ) and 0.0133 mm year(-1 ) in the rosuvastatin-treated and placebo-treated groups , respectively ( P = 0.049 ) . This divergence grew with further follow-up : -0.0009 mm year(-1 ) and 0.0131 mm year(-1 ) after 18 months ( P < 0.001 ) and -0.0014 mm year(-1 ) and 0.0131 mm year(-1 ) after 24 months of treatment ( P < 0.001 ) . Results were stronger for the mean common CIMT progression ( based on near and far wall measurements from both left and right common carotid segments ) . CONCLUSION Aggressive LDL-C lowering seems to exert its beneficial effect on atherosclerosis progression during the first 12 months of treatment . This parallels the timing of event reduction seen in clinical trials and suggests that the efficacy of lipid lowering treatment on CIMT progression can be evaluated in trials with a duration of 1 year , given sufficient sample size , high precision of measurements and a treatment effect comparable to that seen in METEOR

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Diet and pravastatin in moderate hypercholesterolaemia: a randomized trial in 215 middle-aged men free from cardiovascular disease.

OBJECTIVE To evaluate the effect of diet and drug intervention separately and combined in the treatment of primary hypercholesterolemia . DESIGN The study was conducted as a r and omized , placebo-controlled factorial trial , double-blinded for drug intervention . SETTING Subjects were recruited from a population -based cholesterol screening programme . SUBJECTS 215 middle-aged men with primary hypercholesterolemia , free from cardiovascular disease . INTERVENTIONS Subjects were r and omized to one of four intervention groups : ( 1 ) placebo and US National Cholesterol Education Program step 1 diet ; ( 2 ) placebo and step 2 diet ; ( 3 ) pravastatin 20 mg day-1 and step 1 diet ; or ( 4 ) pravastatin 20 mg day-1 and step 2 diet . The intervention period was 6 months . MAIN OUTCOME MEASUREMENTS Efficacy measurements included : serum total cholesterol , HDL cholesterol , triglycerides , apolipoproteins A1 and B. LDL cholesterol was calculated . For safety , values of ALAT , ASAT and CK were measured . RESULTS In the group receiving the step 1 diet only , lipid values were stable during the study period . In the placebo group on the step 2 diet , total cholesterol decreased by 6.3 % ( 0.47 mmol L-1 ( 95 % CI : 0.28 , 0.67 ) ) during 6 months . In the group receiving both pravastatin and the step 1 diet , there was a mean reduction in serum total cholesterol of 19.4 % ( 1.46 mmol L-1 ( 95 % CI : 1.20 , 1.72 ) ) . In the group treated with pravastatin and the step 2 diet , the 6 months of data show a reduction of 20.7 % ( 1.55 mmol L-1 ( 95 % CI : 1.30 , 1.80 ) ) . CONCLUSIONS If drug therapy with a HMG-CoA reductase inhibitor is considered necessary , a step 2 diet has no additional lipid-lowering effect compared with a step 1 diet in men with primary hypercholesterolaemia . However , favourable ' side-effects ' of a lipid-lowering diet , such as weight loss and lowering of blood pressure , may still warrant a low-fat diet in these cases

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Disease-free intervals after partial ileal bypass in patients with coronary heart disease and hypercholesterolemia: report from the Program on the Surgical Control of the Hyperlipidemias (POSCH).

OBJECTIVES We sought to analyze the disease-free intervals and calculate the freedom from atherosclerosis events in the Program on the Surgical Control of the Hyperlipidemias ( POSCH ) . BACKGROUND The POSCH study was a r and omized , secondary lipid/atherosclerosis intervention trial that provided strong evidence for reduction in atherosclerosis progression as demonstrated by clinical and arteriographic end points . The 417 control group patients received American Heart Association phase II diet instruction , and the 421 intervention group patients received identical dietary instruction and underwent a partial ileal bypass operation . METHODS Four outcome measures were determined : 1 ) overall mortality , 2 ) coronary heart disease mortality , 3 ) coronary heart disease mortality and confirmed nonfatal myocardial infa rct ion , and 4 ) coronary/cardiac interventions . RESULTS An overall mortality rate of 10 % occurred at 6.7 years in the control group and 9.4 years in the intervention group , for a gain in disease-free interval of 2.7 years in the intervention group ( p = 0.032 ) . A coronary heart disease mortality rate of 8 % occurred at 7.2 years in the control group and 11 years in the intervention group , for a gain of 3.8 years ( p = 0.046 ) . Twenty percent of patients demonstrated the combined end point of coronary heart disease mortality and confirmed nonfatal myocardial infa rct ion at 5.9 years in the control group and 11.4 years in the intervention group , for a gain of 5.5 years ( p < 0.001 ) . Twenty-five percent of patients underwent either coronary artery bypass graft surgery , percutaneous transluminal coronary angioplasty or heart transplantation at 5.4 years in the control group and 12.4 years in the intervention group , for a gain of 7 years ( p < 0.001 ) . CONCLUSIONS The marked lipid modification achieved by partial ileal bypass in the POSCH trial led to demonstrable increases in the disease-free intervals for overall mortality , coronary heart disease mortality , coronary heart disease mortality and confirmed nonfatal myocardial infa rct ion , and coronary intervention procedures . For the clinician and the patient , estimation of disease-free intervals may be more relevant than assessment of differences in incidence rates and risk ratios

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Preventing the next event in the elderly: the PROSPER perspective.

Statins reduce coronary and cerebrovascular morbidity and mortality in middle-aged individuals but their efficacy and safety in elderly people has not been confirmed . Several clinical trials including the Cholesterol and Recurrent Events ( CARE ) and Long-term Intervention with Pravastatin in Ischemic Disease ( LIPID ) , have sub-analysed their results for the ' elderly ' cohort , but the Prospect i ve Study of Pravastatin in the Elderly at Risk ( PROSPER ) trial is the first trial to specifically evaluate the benefits of statin therapy on vascular risk in elderly men and women . The results have shown that pravastatin , given for 3 years , reduced the risk of coronary heart disease in elderly individuals . Within this same time frame , there was no significant benefit on the risk reduction of stroke but there was a trend to reduce the risk of transient ischemic attacks . It was discovered that those patients with the lowest baseline high-density lipoprotein cholesterol gained the most benefit from the intervention . Drug interactions between pravastatin and the concomitant medications seen in this elderly cohort , was not a significant clinical issue . Therefore , PROSPER extends to elderly individuals the treatment strategy currently used in middle-aged people

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Women in the POSCH trial. Effects of aggressive cholesterol modification in women with coronary heart disease. The POSCH Group. Program on the Surgical Control of the Hyperlipidemias.

The Program on the Surgical Control of the Hyperlipidemias ( POSCH ) provided the clearest and the most convincing evidence supporting the beneficial effects of cholesterol lowering in hypercholesterolemic survivors of a myocardial infa rct ion . In POSCH , 78 of the 838 patients ( 9.3 % ) were women , with 32 r and omized to the diet-control group and 46 to the diet plus partial ileal bypass surgery-intervention group . At 5 years , the mean per cent change from baseline was -23.9 % for total plasma cholesterol ( p < 0.0001 ) , -36.1 % for low-density lipoprotein cholesterol ( p < 0.0001 ) , and + 8.5 % for high-density lipoprotein cholesterol ( p = not significant ) . Because of the small number of women , no statistically significant changes in clinical event rates were observed between the control and the surgery groups . A comparison of 162 coronary arteriography film pairs in the POSCH women , between baseline and 3 , 5 , 7 , and 10 years , consistently showed less disease progression in the surgery group ( p = 0.013 for combined assessment s of the baseline to the longest follow-up film ) . Because the lipid and coronary arteriography findings in the POSCH women paralleled these findings in the total POSCH population and in the POSCH men , and because the arteriography changes in POSCH have previously been demonstrated to be statistically significant surrogate end points for certain clinical events and predictors of overall and atherosclerotic coronary heart disease mortality rates , we conclude that the lipid modification achieved in the POSCH women by partial ileal bypass reduced their atherosclerosis progression . The POSCH findings in women support the aggressive treatment of hyperlipidemia in the general management of atherosclerosis in women

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

The West of Scotland coronary prevention study: economic benefit analysis of primary prevention with pravastatin

Abstract Objective : To estimate the economic efficiency of using pravastatin to prevent the transition from health to cardiovascular disease in men with hypercholesterolaemia . Design : Economic benefit analysis based on data from the West of Scotl and coronary prevention study . Treatment specific hazards of developing cardiovascular disease according to various definitions were estimated . Scottish record linkage data provided disease specific survival . Cost estimates were based on extracontractual tariffs and event specific average lengths of stay calculated from the West of Scotl and coronary prevention study . Subjects : Men with hypercholesterolaemia similar to the subjects in the West of Scotl and coronary prevention study . Main outcome : Cost consequences , the number of transitions from health to cardiovascular disease prevented , the number needed to start treatment , and cost per life year gained . Results : If 10 000 of these men started taking pravastatin , 318 of them would not make the transition from health to cardiovascular disease ( number needed to treat , 31.4 ) , at a net discounted cost of £ 20 m over 5 years . These benefits imply an undiscounted gain of 2460 years of life , and thus £ 8121 per life year gained , or £ 20 375 per life year gained if benefits are discounted . Restriction to the 40 % of men at highest risk reduces the number needed to treat to 22.5 ( £ 5601 per life year gained ( undiscounted ) and £ 13 995 per life year gained ( discounted ) ) . Conclusions : In subjects without evidence of prior myocardial infa rct ion but who have hypercholesterolaemia , the use of pravastatin yields substantial health benefits at a cost that is not prohibitive overall and can be quite efficient in selected high risk subgroups . Key messages The West of Scotl and coronary prevention study showed that pravastatin can prevent cardiovascular disease in men with hypercholesterolaemia So far , reports have deemed this prevention unjustified due to adverse economic implication s This analysis , based on data from the West of Scotl and coronary prevention study and extensive data from the Scottish record linkage system , shows that using pravastatin in this way is worth considering because of its substantial clinical benefit at a reasonable cost Practitioners must now consider using pravastatin to prevent cardiovascular disease in men with hypercholesterolaemia Increased economic efficiency may be obtained by restricting prevention to patients with additional risk

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Fluvastatin and lifestyle modification for reduction of carotid intima-media thickness and left ventricular mass progression in drug-treated hypertensives.

OBJECTIVES The Hypertension High Risk Management trial ( HYRIM ) investigated the effect of fluvastatin treatment and lifestyle intervention on development of carotid intima-media thickness ( IMT ) in drug-treated hypertensive patients . METHODS AND RESULTS HYRIM was a placebo-controlled , 2 x 2 factorial trial in which 568 drug-treated hypertensive men aged 40 - 74 years with total cholesterol 4.5 - 8.0 mmol/L , triglycerides < 4.5 mmol/L , body mass index 25 - 35 kg/m2 , and a sedentary lifestyle were r and omized to receive either fluvastatin , 40 mg daily , or placebo , and either intensive lifestyle intervention ( physical activity and diet ) or usual care ( treatment of hypertension and other disorders by own private physician ) . Carotid IMT was assessed by B-mode ultrasound vasculography and left ventricular ( LV ) mass was calculated from ultrasound recordings of the heart . Fluvastatin alone reduced the primary study endpoint of 4-year development of IMT in the common carotid artery ( CCA ) compared with placebo ( p=0.0297 ) . Carotid bulb IMT progression over 4 years was also significantly ( p=0.0214 ) reduced by fluvastatin compared with placebo . Fluvastatin significantly lowered LDL-C levels ( mean net difference through 4 years , 0.6 mmol/L ; p<0.0001 ) , and reduced the 2-year development of LV mass ( p=0.0144 ) compared with placebo . Lifestyle intervention had no significant effect on LDL-C , carotid IMT or LV mass , and did not increase the effects of fluvastatin . CONCLUSIONS In drug-treated hypertensive patients in a usual care setting , fluvastatin treatment reduces progression of carotid IMT and LV mass

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Once‐daily pravastatin in patients with primary hypercholesterolemia: A dose‐response study

This multicenter , double‐blind , placebo‐controlled study was conducted to evaluate dose‐response effects and safety of once‐daily administration of pravastatin , a new inhibitor of 3‐hydroxy‐3‐methylglutaryl coenzyme A ( HMG‐CoA ) reductase . Pravastatin 5 , 10 , 20 , 40 mg or placebo was administered at bedtime to 150 patients with primary hypercholesterolemia inadequately controlled on a low‐fat , low‐cholesterol ( AHA Phase I ) diet . After 8 weeks of treatment , pravastatin produced dose‐dependent reductions in low‐density lipoprotein ( LDL ) cholesterol of 19.2 to 34.1 % ( p⩽.001 vs. baseline and placebo ) and reductions in total cholesterol of 14.3 to 25.1 % ( p⩽.01 to p⩽.001 vs. placebo and p⩽.001 vs. baseline ) . The relationship between the loge dose of pravastatin and decrease in LDL cholesterol was linear ( p<0.002 ) . High‐density‐lipoprotein cholesterol increased up to 11.7 % and triglycerides decreased by as much as 23.9 % . Pravastatin was well tolerated ; no patient withdrew from the study as a consequence of treatment‐related adverse events . Despite its relatively short serum half‐life of approximately 2 h , once‐daily administration of pravastatin provides a safe and effective means of reducing elevated LDL and total cholesterol

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

[Statin therapy for hypertensive patients].

BACKGROUND The majority of cardiovascular events and deaths attributable to both raised blood pressure and dyslipidaemia occur in subjects with relatively " normal " blood pressure and lipid levels respectively . The study was design ed to evaluate the potential benefits of cholesterol lowering in the primary prevention of coronary heart disease in hypertensive subjects with average and below average levels of serum cholesterol . MATERIAL AND METHODS Out of 19 342 hypertensive subjects ( aged 40 - 79 ) who were initially r and omized to one of two antihypertensive treatment strategies in the Anglo-Sc and inavian Cardiac Outcomes Trial ( ASCOT ) , 10 305 subjects with total cholesterol levels < or = 6.5 mmol/L were additionally r and omized to either 10 mg atorvastatin or placebo . The primary endpoint was non-fatal myocardial infa rct ion or fatal coronary heart disease . RESULTS The lipid arm of the study was prematurely stopped after a median follow-up period of 3.3 years . One hundred events occurred in those r and omized to atorvastatin compared to 154 events in those receiving placebo , a 36 % relative risk reduction ( p = 0.0005 ) in the primary endpoint . Among secondary and tertiary endpoints , stroke was reduced with 27 % ( p = 0.02 ) . There was a non-significant 13 % reduction in total mortality . Non-cardiovascular mortality was similar in the two treatment limbs of the trial . After three years of follow-up , atorvastatin lowered total serum cholesterol by 1.1 mmol/L compared with placebo . INTERPRETATION Treatment with 10 mg atorvastatin o.d . in hypertensive patients at moderate risk gives a significant risk reduction of coronary heart disease , independent of baseline level of total cholesterol

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effects of atorvastatin on dyslipidaemia in uraemic patients on peritoneal dialysis.

BACKGROUND Our purpose was to evaluate the efficacy and safety of atorvastatin , a potent cholesterol- and triglyceride-lowering agent , in peritoneal dialysis patients with dyslipidaemia . METHODS Peritoneal dialysis patients with hypercholesterolaemia were treated for 4 months with atorvastatin at a starting dose of 10 mg . The dose could be increased to 20 or 40 mg in order to achieve the following targets : plasma LDL-cholesterol of 130 mg/dl for primary prevention of coronary heart disease , plasma LDL cholesterol of 100 mg/dl for secondary prevention , and plasma triglycerides of 200 mg/dl . Plasma lipid profile and liver and muscle enzyme levels were assessed at baseline and then monthly during treatment . RESULTS Thirty-one patients with hypercholesterolaemia were included ( 16 males and 15 females ; mean age 57+/-16 years ; mean duration of peritoneal dialysis 27+/-17 months ) . Nineteen of the patients also had hypertriglyceridaemia and seven had diabetes . Twenty patients had no coronary history ( primary prevention ) , whereas nine had experienced a coronary event ( secondary prevention ) . In the primary and the secondary prevention patients , mean LDL-cholesterol levels ( mg/dl ) decreased significantly by 42 and 46 % from 204+/-23 to 119+/-27 ( P<0 . 001 ) and 198+/-37 to 104+/-21 ( P<0.001 ) , and mean triglyceride levels ( mg/dl ) decreased by 37 and 26 % from 289+/-132 to 186+/-92 ( P<0.001 ) and 201+/-62 to 150+/-54 ( P<0.001 respectively ) . Nineteen primary prevention and seven secondary prevention patients achieved the LDL-cholesterol target . The triglyceride target was achieved by 15 of the 19 hypertriglyceridaemic patients . Two patients stopped treatment ( one because of gastrointestinal disturbances , the other because of an allergic skin reaction ) . After 4 months , there were no changes in enzyme levels . CONCLUSION Atorvastatin is an effective and safe lipid-lowering agent for peritoneal dialysis patients with mixed dyslipidaemia

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Primary prevention of cardiovascular diseases among hypercholesterolemic Japanese with a low dose of pravastatin.

The MEGA Study was Japan 's first primary prevention trial of cardiovascular disease ( CVD ) by cholesterol lowering with low-dose pravastatin . Included were postmenopausal women aged < or = 70 years and men aged 40 - 70 years with mildly elevated total cholesterol ( TC ) level 220 - 270 mg/dL. In all , 8214 out patients were r and omly assigned to receive diet alone or diet plus pravastatin 10 - 20mg/day for an average follow-up of 5.3 years . The primary endpoint was a composite of fatal and nonfatal MI , angina , cardiac and sudden death , and coronary revascularization . TC was reduced by 11.5 % in the diet plus pravastatin group versus 2.1 % in the diet alone group . LDL-C was reduced by 18 % and 3.2 % in the two groups , respectively . TC was reduced to < 220 mg/dL and LDL-C to < 130 mg/dL in patients in the diet plus pravastatin group . There was a significant 33 % reduction of the primary endpoint in the diet plus pravastatin group compared with the diet alone group . Notable findings of the MEGA Study included the observation that despite pravastatin 's modest LDL-C reductions in this low-risk population , a 33 % reduction of CHD events was achieved . Even though 68 % of patients were women , who have been traditionally considered at less risk than men , significant CHD risk reduction was observed across all groups

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. Report of the Program on the Surgical Control of the Hyperlipidemias (POSCH)

BACKGROUND AND METHODS The Program on the Surgical Control of the Hyperlipidemias ( POSCH ) , a r and omized clinical trial , was design ed to test whether cholesterol lowering induced by the partial ileal bypass operation would favorably affect overall mortality or mortality due to coronary heart disease . The study population consisted of 838 patients ( 417 in the control group and 421 in the surgery group ) , both men ( 90.7 percent ) and women , with an average age of 51 years , who had survived a first myocardial infa rct ion . The mean follow-up period was 9.7 years . RESULTS When compared with the control group at five years , the surgery group had a total plasma cholesterol level 23.3 percent lower ( 4.71 + /- 0.91 vs. 6.14 + /- 0.89 mmol per liter [ mean + /- SD ] ; P less than 0.0001 ) , a low-density lipoprotein cholesterol level 37.7 percent lower ( 2.68 + /- 0.78 vs. 4.30 + /- 0.89 mmol per liter ; P less than 0.0001 ) , and a high-density lipoprotein cholesterol level 4.3 percent higher ( 1.08 + /- 0.26 vs. 1.04 + /- 0.25 mmol per liter ; P = 0.02 ) . Overall mortality and mortality due to coronary heart disease were reduced , but not significantly so ( deaths overall [ control vs. surgery ] , 62 vs. 49 , P = 0.164 ; deaths due to coronary disease , 44 vs. 32 , P = 0.113 ) . The overall mortality in the surgery subgroup with an ejection fraction greater than or equal to 50 percent was 36 percent lower ( control vs. surgery , 39 vs. 24 ; P = 0.021 ) . The value for two end points combined -- death due to coronary heart disease and confirmed nonfatal myocardial infa rct ion -- was 35 percent lower in the surgery group ( 125 vs. 82 events ; P less than 0.001 ) . During follow-up , 137 control-group and 52 surgery-group patients underwent coronary-artery bypass grafting ( P less than 0.0001 ) . A comparison of base-line coronary arteriograms with those obtained at 3 , 5 , 7 , and 10 years consistently showed less disease progression in the surgery group ( P less than 0.001 ) . The most common side effect of partial ileal bypass was diarrhea ; others included occasional kidney stones , gallstones , and intestinal obstruction . CONCLUSIONS Partial ileal bypass produces sustained improvement in the blood lipid patterns of patients who have had a myocardial infa rct ion and reduces their subsequent morbidity due to coronary heart disease . The role of this procedure in the management of hypercholesterolemia remains to be determined . These results provide strong evidence supporting the beneficial effects of lipid modification in the reduction of atherosclerosis progression

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Standard-dose statin therapy provides incremental clinical benefits in normocholesterolemic diabetic patients.

BACKGROUND R and omized trials have established statins as an agent for prevention of coronary heart disease ( CHD ) . The purpose of this study was to assess the hypothesis that st and ard-dose statin therapy has a beneficial effect in normocholesterolemic diabetic patients with CHD . METHODS AND RESULTS A prospect i ve , r and omized , open , blinded-endpoint trial was conducted from 2002 to 2004 at 55 hospitals in Japan to evaluate the effect of statins on subsequent cardiovascular events . A total number of 1,016 CHD patients ( 301 patients with type 2 diabetes mellitus [ DM ] and 715 non-DM patients ) with serum total cholesterol levels of 180 - 240 mg/dl were r and omly divided into non-statin and statin treatments . Clinical parameters were comparable between DM and non-DM groups . Serum low-density lipoprotein (LDL)-cholesterol levels were equally decreased after statin treatment in the 2 groups . Statin treatment improved prognosis in both the DM and non-DM groups ; however , the number needed to treat ( NNT ) and relative risk reduction ( RRR ) were remarkable especially in the DM group ( NNT=8 , RRR=67 % ) compared with the non-DM group ( NNT=30 , RRR=24 % ) . CONCLUSIONS St and ard-dose statin therapy provides incremental clinical benefits in DM patients with normal cholesterol levels compared with non-DM patients . The data suggest that DM patients may enjoy the pleiotropic effects of statins , independent of the LDL-cholesterol lowering effects of these agents

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Comparative efficacy study of atorvastatin vs simvastatin, pravastatin, lovastatin and placebo in type 2 diabetic patients with hypercholesterolaemia.

Although there is little information from primary or secondary prevention trials on cholesterol-lowering medication in diabetic patients , the reduction of elevated cholesterol is widely recommended for this group . The American Diabetes Association ( ADA ) recommends drug therapy in diabetic patients if low density lipoprotein (LDL)-cholesterol remains at > 130 mg/dl , or > 100 mg/dl in patients with macroangiopathy , after dietary intervention . When cholesterollowering medication is indicated , the choice of the drug must take into account the other lipid abnormalities that are often present and the need to maintain optimal glycaemic control . In the present study we compared the efficacy and safety of the novel HMG-CoA reductase inhibitor atorvastatin at the dose of 10 mg/day with simvastatin , lovastatin and pravastatin at doses of 10 , 20 and 20 mg/day , respectively , and placebo , in type 2 diabetic patients with moderate elevation of LDL-cholesterol with or without elevation of triglycerides . All the quoted agents are enzyme inhibitors effective in lowering LDL-cholesterol in humans . The efficacy endpoints were the mean per cent changes in plasma LDL-cholesterol ( primary ) , total cholesterol , triglycerides , and high-density lipoprotein (HDL)-cholesterol concentrations from baseline to the end of treatment ( 24 weeks ) . Atorvastatin at a dose of 10 mg/day produced : ( 1 ) a significant reduction in LDL-cholesterol ( -37 % ) in comparison with equivalent doses of simvastatin ( -26 % ) , pravastatin ( -23 % ) , lovastatin ( -21 % ) , and placebo ( -1 % ) ; ( 2 ) HDL-cholesterol increases ( 7.4 % ) comparable to or greater than those obtained with simvastatin ( 7.1 % ) , pravastatin ( 3.2 % ) , lovastatin ( 7.21 % ) , and placebo ( -0.5 % ) ; ( 3 ) a significantly greater reduction in total cholesterol ( - 29 % ) than that obtained with simvastatin ( -21 % ) , pravastain ( -16 % ) , lovastatin ( -18 % ) , and placebo ( 1 % ) ; and ( 4 ) a significantly greater reduction in triglycerides than that obtained with all the other drugs and placebo . In all treatment groups no significant variation in fibrinogen concentration was observed . All reductase inhibitors studied had similar levels of tolerance . There were no incidents of persistent elevations of serum aminotransferases or myositis

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Simvastatin in the treatment of asthma: lack of steroid-sparing effect

Background Statins have anti-inflammatory actions which in theory are potentially beneficial in asthma . Small trials have failed to show a significant benefit , but a systematic study to evaluate the steroid-sparing effect of statin treatment has not been carried out . Methods A r and omised , placebo-controlled , crossover trial was conducted of simvastatin 40 mg at night with simultaneous stepwise reduction of fluticasone propionate dose until loss of control occurred , followed by an increase until regain of control ( ‘ minimum ’ dose required ) in 51 patients with asthma and sputum eosinophils ( steroid-free ) ≥2 % . Results 43 patients completed the study . There was no significant difference in ‘ minimum ’ inhaled corticosteroid ( ICS ) dose requirement between simvastatin and placebo : ( median ( IQR ) 50 μg daily ( 0–250 ) vs 100 μg daily ( 0–250 ) , p=0.931 ) . ‘ Minimum ’ dose distribution was similar ( p=0.269 ) . The fluticasone dose at which loss of control occurred did not differ significantly between simvastatin and placebo ( p=0.404 ) . In patients with loss of control in both treatment arms , fluticasone dose at loss of control was similar with simvastatin and placebo ( median ( IQR ) 50 μg daily ( 0–100 ) for both , p=0.620 ) . In those patients who reached 0 μg/day ( n=18 ) , Astma Control Question naire ( ACQ ) was lower ( p=0.037 ) , forced expiratory volume in 1 s ( FEV1 ) higher ( p<0.01 ) and sputum eosinophils lower with simvastatin compared with placebo ( 9.5 % compared with 25.4 % , p=0.033 ) . Conclusions Simvastatin does not have clinical ly important steroid-sparing effects in patients with eosinophilic asthma . In the absence of steroid , simvastatin is associated with minor improvements in symptoms and lung function , and a reduction in sputum eosinophils . Clinical trial number ACTRN12606000531516

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

A randomized trial of rosuvastatin in the prevention of venous thromboembolism.

BACKGROUND Controversy persists regarding the extent of shared pathways between arterial and venous thrombosis and whether treatments of known efficacy for one disease process have consistent benefits for the other . Observational studies have yielded variable estimates of the effect of statin therapy on the risk of venous thromboembolism , and evidence from r and omized trials is lacking . METHODS We r and omly assigned 17,802 apparently healthy men and women with both low-density lipoprotein ( LDL ) cholesterol levels of less than 130 mg per deciliter ( 3.4 mmol per liter ) and high-sensitivity C-reactive protein levels of 2.0 mg per liter or higher to receive rosuvastatin , 20 mg per day , or placebo . We followed participants for the first occurrence of pulmonary embolism or deep-vein thrombosis and performed analyses of the data on an intention-to-treat basis . RESULTS During a median follow-up period of 1.9 years ( maximum , 5.0 ) , symptomatic venous thromboembolism occurred in 94 participants : 34 in the rosuvastatin group and 60 in the placebo group . The rates of venous thromboembolism were 0.18 and 0.32 event per 100 person-years of follow-up in the rosuvastatin and placebo groups , respectively ( hazard ratio with rosuvastatin , 0.57 ; 95 % confidence interval [ CI ] , 0.37 to 0.86 ; P=0.007 ) ; the corresponding rates for unprovoked venous thromboembolism ( i.e. , occurring in the absence of a known malignant condition , trauma , hospitalization , or surgery ) were 0.10 and 0.17 ( hazard ratio , 0.61 ; 95 % CI , 0.35 to 1.09 ; P=0.09 ) and for provoked venous thromboembolism ( i.e. , occurring in patients with cancer or during or shortly after trauma , hospitalization , or surgery ) , 0.08 and 0.16 ( hazard ratio , 0.52 ; 95 % CI , 0.28 to 0.96 ; P=0.03 ) . The rates of pulmonary embolism were 0.09 in the rosuvastatin group and 0.12 in the placebo group ( hazard ratio , 0.77 ; 95 % CI , 0.41 to 1.45 ; P=0.42 ) , whereas the rates of deep-vein thrombosis only were 0.09 and 0.20 , respectively ( hazard ratio , 0.45 ; 95 % CI , 0.25 to 0.79 ; P=0.004 ) . Consistent effects were observed in all the subgroups examined . No significant differences were seen between treatment groups in the rates of bleeding episodes . CONCLUSIONS In this trial of apparently healthy persons , rosuvastatin significantly reduced the occurrence of symptomatic venous thromboembolism . ( Clinical Trials.gov number , NCT00239681 .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Baseline risk factors and their association with outcome in the West of Scotland Coronary Prevention Study. The West of Scotland Coronary Prevention Study Group.

The West of Scotl and Coronary Prevention Study recently demonstrated the benefits of pravastatin therapy in the prevention of coronary heart disease events in middle-aged hypercholesterolemic men without prior myocardial infa rct ion . We present an analysis of the influence of baseline risk factors on coronary events and total mortality in the trial , and their interaction with therapy , using the Cox proportional hazards model . The multivariate predictors of fatal or nonfatal coronary events were treatment allocation ( pravastatin or placebo ) , current smoking , diabetes mellitus , nitrate consumption , minor electrocardiographic abnormalities , angina pectoris , family history of premature coronary death , widowhood , blood pressure , and total cholesterol/high density lipoprotein cholesterol ratio . Independent of other risk factors , pravastatin reduced the risk of definite coronary heart disease death or nonfatal myocardial infa rct ion by 32 % ( 95 % confidence interval 17 to 44 , p = 0.0001 ) , definite or suspected coronary heart disease death by 35 % ( 3 to 56 , p = 0.035 ) , cardiovascular death by 33 % ( 4 to 53 , p = 0.027 ) , coronary revascularization procedures by 38 % ( 11 to 56 , p = 0.009 ) , and all-cause mortality by 24 % ( 2 to 41 , p = 0.037 ) . The 5-year risk of fatal or nonfatal myocardial infa rct ion , calculated using the predictors identified in the Cox analysis , ranged from < 4.4 % in the lowest quartile of risk to > 9.6 % in the highest quartile . The proportional benefit achieved by pravastatin was independent of other risk factors ; hence , the absolute benefit of therapy was greatest in subjects with the highest baseline risk . Such subjects can be identified easily in the population and deserve high priority for treatment

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial

BACKGROUND Type 2 diabetes is associated with a substantially increased risk of cardiovascular disease , but the role of lipid-lowering therapy with statins for the primary prevention of cardiovascular disease in diabetes is inadequately defined . We aim ed to assess the effectiveness of atorvastatin 10 mg daily for primary prevention of major cardiovascular events in patients with type 2 diabetes without high concentrations of LDL-cholesterol . METHODS 2838 patients aged 40 - 75 years in 132 centres in the UK and Irel and were r and omised to placebo ( n=1410 ) or atorvastatin 10 mg daily ( n=1428 ) . Study entrants had no documented previous history of cardiovascular disease , an LDL-cholesterol concentration of 4.14 mmol/L or lower , a fasting triglyceride amount of 6.78 mmol/L or less , and at least one of the following : retinopathy , albuminuria , current smoking , or hypertension . The primary endpoint was time to first occurrence of the following : acute coronary heart disease events , coronary revascularisation , or stroke . Analysis was by intention to treat . FINDINGS The trial was terminated 2 years earlier than expected because the prespecified early stopping rule for efficacy had been met . Median duration of follow-up was 3.9 years ( IQR 3.0 - 4.7 ) . 127 patients allocated placebo ( 2.46 per 100 person-years at risk ) and 83 allocated atorvastatin ( 1.54 per 100 person-years at risk ) had at least one major cardiovascular event ( rate reduction 37 % [ 95 % CI -52 to -17 ] , p=0.001 ) . Treatment would be expected to prevent at least 37 major vascular events per 1000 such people treated for 4 years . Assessed separately , acute coronary heart disease events were reduced by 36 % ( -55 to -9 ) , coronary revascularisations by 31 % ( -59 to 16 ) , and rate of stroke by 48 % ( -69 to -11 ) . Atorvastatin reduced the death rate by 27 % ( -48 to 1 , p=0.059 ) . No excess of adverse events was noted in the atorvastatin group . INTERPRETATION Atorvastatin 10 mg daily is safe and efficacious in reducing the risk of first cardiovascular disease events , including stroke , in patients with type 2 diabetes without high LDL-cholesterol . No justification is available for having a particular threshold level of LDL-cholesterol as the sole arbiter of which patients with type 2 diabetes should receive statins . The debate about whether all people with this disorder warrant statin treatment should now focus on whether any patients are at sufficiently low risk for this treatment to be withheld

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effects of lovastatin on the immune system.

Laboratory investigations have demonstrated that blockade of HMG-CoA reductase in vitro reduces lymphocyte proliferation in response to mitogens as well as other facets of the immune system , such as natural killer cell cytotoxicity . However , in this r and omized and double-blind clinical investigation , treatment with 20-mg lovastatin for 6 months did not significantly alter several enumerative and functional characteristics of circulating immune cells

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Influence of pravastatin and plasma lipids on clinical events in the West of Scotland Coronary Prevention Study (WOSCOPS).

BACKGROUND The West of Scotl and Coronary Prevention Study was a primary prevention trial that demonstrated the effectiveness of pravastatin ( 40 mg/d ) in reducing morbidity and mortality from coronary heart disease ( CHD ) in moderately hypercholesterolemic men . The present analysis examines the extent to which differences in LDL and other plasma lipids both at baseline and on treatment influenced CHD risk reduction . METHODS AND RESULTS Relationships between baseline lipid concentrations and incidence of all cardiovascular events and between on-treatment lipid concentrations and risk reduction in patients taking pravastatin were examined by use of Cox regression models and by division of the cohort into quintiles . Variation in plasma lipids at baseline did not influence the relative risk reduction generated by pravastatin therapy . Fall in LDL level in the pravastatin-treated group did not correlate with CHD risk reduction in multivariate regression . Furthermore , maximum benefit of an approximately 45 % risk reduction was observed in the middle quintile of LDL reduction ( mean 24 % fall ) ; further mean decrements in LDL ( up to 39 % ) were not associated with a greater decrease in CHD risk . Comparison of event rates between placebo- and pravastatin-treated subjects with the same LDL cholesterol level provided evidence for an apparent treatment effect that was independent of LDL . CONCLUSIONS We conclude that the treatment effect of 40 mg/d of pravastatin is proportionally the same regardless of baseline lipid phenotype . There is no CHD risk reduction unless LDL levels are reduced , but a fall in the range of 24 % is sufficient to produce the full benefit in patients taking this dose of pravastatin . LDL reduction alone does not appear to account entirely for the benefits of pravastatin therapy

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Statin Cost-Effectiveness in the United States for People at Different Vascular Risk Levels

Background —Statins reduce the rates of heart attacks , strokes , and revascularization procedures ( ie , major vascular events ) in a wide range of circumstances . R and omized controlled trial data from 20 536 adults have been used to estimate the cost-effectiveness of prescribing statin therapy in the United States for people at different levels of vascular disease risk and to explore whether wider use of generic statins beyond the population s currently recommended for treatment in clinical guidelines is indicated . Methods and Results —R and omized controlled trial data , an internally vali date d vascular disease model , and US costs of statin therapy and other medical care were used to project lifetime risks of vascular events and evaluate the cost-effectiveness of 40 mg simvastatin daily . For an average of 5 years , allocation to simvastatin reduced the estimated US costs of hospitalizations for vascular events by ≈20 % ( 95 % CI , 15 to 24 ) in the different subcategories of participants studied . At a daily cost of $ 1 for 40 mg generic simvastatin , the estimated costs of preventing a vascular death within the 5-year study period ranged from a net saving of $ 1300 ( 95 % CI , $ 15 600 saving to $ 13 200 cost ) among participants with a 42 % 5-year major vascular event risk to a net cost of $ 216 500 ( $ 123 700 to $ 460 000 cost ) among those with a 12 % 5-year risk . The costs per life year gained with lifetime simvastatin treatment ranged from $ 2500 ( −$40 to $ 3820 ) in people aged 40 to 49 years with a 42 % 5-year major vascular event risk to $ 10 990 ( $ 9430 to $ 14 700 ) in people aged 70 years and older with a 12 % 5-year risk . Conclusions —Treatment with generic simvastatin appears to be cost-effective for a much wider population in the United States than that recommended by current guidelines

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effects of atorvastatin on kidney outcomes and cardiovascular disease in patients with diabetes: an analysis from the Collaborative Atorvastatin Diabetes Study (CARDS).

BACKGROUND We examined whether atorvastatin affects diabetic kidney disease and whether the effect of atorvastatin on cardiovascular disease ( CVD ) varies by kidney status in patients with diabetes . STUDY DESIGN The Collaborative Atorvastatin Diabetes Study ( CARDS ) r and omized placebo-controlled trial . SETTING & PARTICIPANTS Patients with type 2 diabetes and no prior CVD ( n = 2,838 ) . INTERVENTION R and om allocation to atorvastatin , 10 mg/d , or placebo , with a median follow-up of 3.9 years . OUTCOMES Estimated glomerular filtration rate ( eGFR ) , albuminuria , CVD . MEASUREMENTS Baseline and follow-up GFRs were estimated by using the Modification of Diet in Renal Disease Study equation . Urinary albumin-creatinine ratio was measured on spot urine sample s. RESULTS At baseline , 34 % of patients had an eGFR of 30 to 60 mL/min/1.73 m(2 ) . Atorvastatin treatment was associated with a modest improvement in annual change in eGFR ( net , 0.18 mL/min/1.73 m(2)/y ; 95 % confidence interval [ CI ] , 0.04 to 0.32 ; P = 0.01 ) that was most apparent in those with albuminuria ( net improvement , 0.38 mL/min/1.73 m(2)/y ; P = 0.03 ) . At baseline , 21.5 % of patients had albuminuria and an additional 6.8 % developed albuminuria during follow-up . Atorvastatin did not influence the incidence of albuminuria ( hazard ratio , 1.49 ; 95 % CI , 0.73 to 3.04 ; P = 0.3 ) or regression to normoalbuminuria ( hazard ratio , 1.19 ; 95 % CI , 0.57 to 2.49 ; P = 0.6 ) . In 970 patients with a moderately decreased eGFR of 30 to 60 mL/min/1.73 m(2 ) , there was a 42 % reduction in major CVD events with treatment , including a 61 % reduction in stroke . This treatment effect was similar to the 37 % ( 95 % CI , 17 to 52 ; P < 0.001 ) reduction in CVD observed in the study overall ( P = 0.4 for the eGFR-treatment interaction ) . LIMITATIONS Low incidence rates of albuminuria and transition to more severe kidney status limit power to detect treatment effects . CONCLUSIONS A modest beneficial effect of atorvastatin on eGFR , particularly in those with albuminuria , was observed . Atorvastatin did not influence albuminuria incidence . Atorvastatin was effective at decreasing CVD in those with and without a moderately decreased eGFR and achieved a high absolute benefit

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Prognosis of hypercholesterolemic patients taking pravastatin for five years: the Chiba Lipid Intervention Program (CLIP) Study.

The Chiba Lipid Intervention Program ( CLIP ) Study was design ed to clarify the prognosis of Japanese hypercholesterolemic patients taking pravastatin for 5 years . Hypercholesterolemic patients ( n = 2,529 ) with a total cholesterol level > or = 220 mg/dl and without histories of ischemic coronary heart disease and /or cerebral infa rct ion were administered pravastatin ( 10 - 20 mg/day ) . Among them , 2,131 took pravastatin fully ( Pravastatin-continued group ) , and 398 discontinued the treatment ( Discontinued group ) . The baseline total cholesterol level was 264.3 + /- 34.7 mg/dl ( mean + /- st and ard deviation ) . The mean reduction rates of total cholesterol and low-density lipoprotein ( LDL ) cholesterol were 18.0 % and 27.2 % , respectively . Mild and moderate adverse events occurred in 86 cases ( 3.6 % ) . Serious adverse events were not observed . Death rates of the pravastatin-continued group and of the discontinued group were 2.6 and 16.0/1,000 persons/year , respectively . Cardiac events ( fatal and nonfatal myocardial infa rct ion , cardiac death , angina pectoris ) in all , occurred in 35 patients ( incidence rate = 2.77/1,000 persons/year ) . In the pravastatin continued group , 9 causes of fatal and nonfatal myocardial infa rct ion occurred ( 0.84/1,000 persons/year ) , whereas in the discontinued group , 4 cases occurred ( 2.06/1,000 persons/ year ) . The risk ratio for cardiac events was correlated with the number of risks . In the low-risk group ( < or = 1 risk ) , decreased rates of LDL-cholesterol were less in the cardiac event group than the non-cardiac event group ( LDL-cholesterol ; 16 % vs 25 % , p = 0.04 ) . These results suggested the following ; 1 ) Pravastatin maintained a cholesterol lowering effect long-term without serious complications . 2 ) Pravastatin administration might reduce the mortality rate and myocardial infa rct ion . 3 ) The combination of multiple risks is a strong factor for a cardiac event in addition to hypercholesterolemia

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Expanded Clinical Evaluation of Lovastatin (EXCEL) study results. I. Efficacy in modifying plasma lipoproteins and adverse event profile in 8245 patients with moderate hypercholesterolemia.

In the Exp and ed Clinical Evaluation of Lovastatin ( EXCEL ) Study , a multicenter , double-blind , diet- and placebo-controlled trial , we evaluated the efficacy and safety of lovastatin in 8245 patients with moderate hypercholesterolemia . Patients were r and omly assigned to receive placebo or lovastatin at a dosage of 20 mg once daily , 40 mg once daily , 20 mg twice daily , or 40 mg twice daily for 48 weeks . Lovastatin produced sustained , dose-related ( P less than .001 ) changes as follows ( for dosages of 20 to 80 mg/d ) : decreased low-density lipoprotein-cholesterol level ( 24 % to 40 % ) , increased high-density lipoprotein-cholesterol level ( 6.6 % to 9.5 % ) , decreased total cholesterol level ( 17 % to 29 % ) , and decreased triglyceride level ( 10 % to 19 % ) . The National Cholesterol Education Program 's low-density lipoprotein-cholesterol level goal of less than 4.14 mmol/L ( 160 mg/dL ) was achieved by 80 % to 96 % of patients , while the less than 3.36 mmol/L ( 130 mg/dL ) goal was achieved by 38 % to 83 % of patients . The difference between lovastatin and placebo in the incidence of clinical adverse experiences requiring discontinuation was small , ranging from 1.2 % at 20 mg twice daily to 1.9 % at 80 mg/d . Successive transaminase level elevations greater than three times the upper limit of normal were observed in 0.1 % of patients receiving placebo and 20 mg/d of lovastatin , increasing to 0.9 % in those receiving 40 mg/d and 1.5 % in those receiving 80 mg/d of lovastatin ( P less than .001 for trend ) . Myopathy , defined as muscle symptoms with a creatine kinase elevation greater than 10 times the upper limit of normal , was found in only one patient ( 0.1 % ) receiving 40 mg once daily and four patients ( 0.2 % ) receiving 80 mg/d of lovastatin . Thus , lovastatin , when added after an adequate trial of a prudent diet , is a highly effective and generally well-tolerated treatment for patients with moderate hypercholesterolemia

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Fluvastatin Prevents Cardiac Death and Myocardial Infarction in Renal Transplant Recipients: Post‐Hoc Subgroup Analyses of the ALERT Study

Renal transplant recipients have a greatly increased risk of premature cardiovascular disease . The ALERT study was a multicenter , r and omized , double‐blind , placebo‐controlled trial of fluvastatin ( 40–80 mg/day ) in 2102 renal transplant recipients followed for 5–6 years . The main study used a composite cardiac end‐point including myocardial infa rct ion , cardiac death and cardiac interventions . Although reduced by fluvastatin , this primary end‐point failed to achieve statistical significance thus precluding analysis of predefined subgroups . Therefore , in the present survival analysis , we used an alternative primary end‐point of cardiac death or definite nonfatal myocardial infa rct ion ( as used in other cardiac outcome trials ) which was significantly reduced by Fluvastatin therapy and permits subgroup analysis . Fluvastatin reduced LDL‐cholesterol by 1 mmol/L compared with placebo , and the incidence of cardiac death or definite myocardial infa rct ion was reduced from 104 to 70 events ( RR 0.65 ; 95 % CI 0.48 , 0.88 ; p = 0.005 ) . Fluvastatin use was associated with reduction in cardiac death or nonfatal myocardial infa rct ion , which achieved statistical significance in many subgroups . The subgroups included patients at lower cardiovascular risk , who were younger , nondiabetic , nonsmokers and without pre‐existing CVD . These data support the early introduction of statins following renal transplantation

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Treatment of early Parkinson's disease

Parkinson 's disease , a progressive neurodegenerative disorder , affects about 1 % of the population over the age of 50 . While it has no cure , it is the only neurodegenerative disorder with a range of medical and neurosurgical treatments that substantially reduce clinical symptoms.1 However , medical management of early Parkinson 's disease is controversial because of the potential risks and benefits to patients . Some clinicians prefer to use levodopa , a dopamine precursor , since it promptly relieves symptoms . Others prescribe dopamine agonists and withhold levodopa because of its long term complications , namely abnormal involuntary movements and potential neurotoxicity . Inevitably , managing the side effects of antiparkinsonian drugs becomes a therapeutic focus along with treating the primary motor abnormalities.1 Extended controlled clinical trials are the only means of obtaining evidence based guidance on the use of dopamine agonists or levodopa for the management of early Parkinson 's disease . The results of a recent multisite , five year , r and omised , double blind study comparing the incidence of dyskinesia with levodopa or ropinirole , a dopamine D2 receptor agonist,2 should sway practitioners towards initial treatment with agonists for early Parkinson 's disease . In contrast to the hypokinesis that characterises Parkinson 's disease , dyskinesias related to antiparkinsonian drugs involve hyperkinetic choreoathetoid , lurching , and jerky movements . These movements are thought

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

[Effect of atorvastatin on carotid intima-medial of thickness of primary hypertension patients of Han nationality in China].

OBJECTIVES To investigate the efficacy of 10 mg or 20 mg atorvastatin + long acting antihypertensive in carotid intima-medial thickness ( IMT ) . METHODS 151 patients of Han nationality in South China with mild hypertensive were r and omly divided into 3 groups : atorvastatin 10 mg group ( n = 50 ) receive 10 mg atorvastatin and amlodipine + benazepril ; atorvastatin 20 mg group ( n = 61 ) receive 20 mg atorvastatin and amlodipine + benazepril ; the control group ( n = 40 ) receive amlodipine + benazepril . The patients were detected IMT , vascular function , lipids and inflammatory factor in pretherapy and every 3 months . RESULTS atorvastatin 10 mg or 20 mg groups have significantly change contrast to control group : ( 1 ) IMT was decreased ( P < 0.01 ) . ( 2 ) Deltadia-P% and Deltadia-N% were increased ( P < 0.01 ) . ( 3 ) LDL-C level was decreased by 30 % in a atorvastatin 10 mg group and 40.48 % in 20 mg group respectively ( P < 0.01 ) . CONCLUSION Atorvastatin delays the development of atherosclerosis in hypertensive patients , improves endothelial function , and strengthens the effect of lipid-lowering

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Cerivastatin, a New Potent Synthetic HMG Co-A Reductase Inhibitor: Effect of 0.2 mg Daily in Subjects With Primary Hypercholesterolemia

Background : Reduction of serum cholesterol , most notably low-density lipoprotein choles terol is associated with reductions in cardiovascular morbidity and mortality . Statins have been shown to effectively reduce low-density lipoprotein cholesterol via inhibition of the hydroxymethyl-coenzyme A ( HMG-CoA ) reductase . Cerivastatin is the most potent HMG- CoA reductase inhibitor currently under study in the United States . Methods and Results : A parallel group , r and omized , placebo-controlled , double-blind , mul ticenter study was conducted to compare the efficacy and safety of three different dosing reg imens of 0.2 mg/day of cerivastatin , a new HMG-CoA reductase inhibitor , in patients with hypercholesterolemia . After a 10-week diet-placebo lead-in period , 319 patients with low- density lipoprotein cholesterol > 160 mg/dL were r and omized to 4 weeks of treatment with one of the following regimens : cerivastatin 0.1 mg twice daily , cerivastatin 0.2 mg once daily with the evening meal , cerivastatin 0.2 mg once daily at bedtime or placebo . All three active treatment groups produced statistically significant ( P < .05 ) changes compared to baseline and placebo in total cholesterol ( 0.1 mg twice daily -18.9 % ; 0.2 mg once daily with the evening meal : -21.9 % ; 0.2 mg once daily at bedtime : -22.1 % ; placebo : 0.0 % ) , low-density lipoprotein cholesterol ( 0.1 mg twice daily : -25.7 % ; 0.2 mg once daily with the evening meal : -29.4 % ; 0.2 mg once daily at bedtime : -30.4 % ; placebo : 1.4 % ) and high-density lipoprotein cholesterol ( 0.1 mg twice daily : 5.3 % ; 0.2 mg once daily with the evening meal : 2.3 % ; 0.2 mg once daily at bedtime : 3.2 % ; placebo : -1.2 % ) . Triglycerides , compared to baseline and placebo , were also reduced by all active treatments ( 0.1 mg twice daily : -11.6 % [ P = .05 ] ; 0.2 mg once daily with the evening meal : -11.6 % [ P = .05 ] ; and 0.2 mg at bed time : -10.9 % [ P = .07 ] ) . The percentage change in total cholesterol and low-density lipopro tein cholesterol after 4 weeks of therapy for the once-daily cerivastatin groups was statisti cally significantly greater ( P < .05 ) than the cerivastatin twice daily regimen . A treatment response was seen by 1 week of therapy and was maximal by 3 weeks . The drug was well tolerated in all three dosing regimens and result ed in no significant increase in biochemical or clinical side effects compared to placebo . Conclusion : Cerivastatin is a novel , highly potent , well-tolerated HMG-CoA reductase inhibitor that produces low-density lipoprotein cholesterol reductions of approximately 30 % when administered at 0.2 mg once a day in the evenings

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Long-term treatment with pitavastatin (NK-104), a new HMG-CoA reductase inhibitor, of patients with heterozygous familial hypercholesterolemia.

The clinical efficacy and safety of pitavastatin ( NK-104 ) , a novel HMG-CoA reductase inhibitor , during long-term treatment , were examined in 25 patients ( male/female=11/14 , mean age=53+/-13 ( mean+/-SD ) years ) with heterozygous familial hypercholesterolemia ( FH ) . After a period on placebo of > 4 weeks , 2 mg/day of pitavastatin was administered for 8 weeks , and the dose was increased to 4 mg/day for up to 104 weeks . Total cholesterol ( TC ) decreased by 31 % from the initial value of 340+/-57 to 237+/-40 mg/dl ( P<0.0001 ) at week 8 . During treatment with the higher dose , TC decreased even further to 212+/-35 mg/dl at week 12 ; it decreased by 37 % from the initial value ( P<0.0001 ) . Similarly , the baseline low-density lipoprotein (LDL)-cholesterol ( LDL-C ) decreased by 41 % at week 8 , and by 49 % at week 12 , from 267+/-61 mg/dl at baseline . These findings indicate a dose-dependent effect of the drug on TC and LDL-C concentrations . To examine whether the levels of circulating matrix metalloproteinases ( MMPs ) and their endogenous inhibitors ( tissue inhibitors of metalloproteinases : TIMPs ) are altered during lipid-lowering therapy , we also measured their plasma levels . The mean levels of MMP-2 and -3 were significantly increased . No significant alteration was found in MMP-9 , TIMP-1 and -2 levels . As for the safety of pitavastatin , adverse reactions were observed in one case ( 4 % ) of subjective and objective symptoms . The effects of pitavastatin on TC and LDL-C were stable during long treatment of patients with heterozygous FH

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Atorvastatin affects low density lipoprotein and non-high density lipoprotein cholesterol relations with apolipoprotein B in type 2 diabetes mellitus: modification by triglycerides and cholesteryl ester transfer protein

Objectives : Non-HDL-cholesterol ( non-HDL-C ) and apolipoprotein ( apo ) B are proposed as treatment targets . The extent to which statin therapy affects relationships of LDL-C and non-HDL-C with apoB was examined in type 2 diabetes . Methods : Analyses were performed in 217 hypertriglyceridaemic type 2 diabetic patients ( Diabetes Atorvastatin Lipid Intervention ( DALI ) cohort ) . 61 patients r and omized to placebo , 70 to 10 mg atorvastatin daily and 65 – 80 mg atorvastin daily completed follow-up . Results : Baseline fasting LDL-C of 2.42 mmol/l and non-HDL-C of 3.69 mmol/l corresponded to the apoB guideline target of 0.90 g/l . During atorvastatin ( 10 and 80 mg daily ) , the LDL-C target was achieved most frequently , and lower LDL-C ( 2.38 and 2.29 mmol/l ) and non-HDL-C ( 3.24 and 3.19 mmol/l ) concentrations corresponded to this apoB goal . Decreases in LDL-C during atorvastatin treatment were negatively related ( p < 0.001 ) , but decreases in non-HDL-C were positively related to changes in triglycerides ( p < 0.001 ) , independently from decreases in apoB ( p < 0.001 for all ) . Decreases in LDL-C and non-HDL-C were positively associated with decreases in cholesteryl ester transfer protein mass ( p < 0.001 ) . Conclusions : During atorvastatin lower LDL-C and non-HDL-C levels correspond to the apoB guideline target , which would favour its use as treatment target

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

C-reactive protein lowering with rosuvastatin in the METEOR study.

OBJECTIVES In addition to its LDL-C-lowering effects , statin treatment reduces the level of C-reactive protein ( CRP ) . Long-term data on this effect in low-risk population s are limited . Furthermore , whether the CRP reduction is a consequence of LDL-C lowering or occurs independently remains unclear . We studied these aspects in the Measuring Effects on intima media Thickness : an Evaluation Of Rosuvastatin ( METEOR ) study , a r and omized placebo-controlled trial amongst 984 low-risk subjects . METHODS METEOR is a r and omized placebo-controlled trial that evaluated the effect of 40 mg of rosuvastatin on 2-year change in carotid intima media thickness ( CIMT ) amongst 984 low-risk patients ( 10-year Framingham risk < 10 % ) with modest CIMT ( CIMT > or = 1.2 and < 3.5 mm ) and elevated LDL-C. CRP levels were measured at baseline and after 2 years of treatment . RESULTS Median baseline CRP was 1.4 mg L(-1 ) . Rosuvastatin lowered CRP significantly compared with placebo : -36 % in the rosuvastatin group versus no change in the placebo group . There was no relation between change in CRP and change in LDL-C ( Spearman correlation : 0.08 ; SE : 0.04 ) . Stratified analyses showed that the CRP-lowering effect was present amongst all strata of baseline characteristics , including baseline lipids and CRP levels . However , the magnitude of CRP reduction was larger amongst women and participants older than 60 years . CONCLUSIONS Rosuvastatin ( 40 mg ) lowers CRP independently from its effects on LDL-C in low-risk subjects with normal baseline CRP levels and modest CIMT

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Changes in sequential coronary arteriograms and subsequent coronary events. Surgical Control of the Hyperlipidemias (POSCH) Group.

OBJECTIVE Assessment of the relationship between changes in sequential coronary arteriograms and subsequent clinical coronary events . DESIGN The Program on the Surgical Control of the Hyperlipidemias , a r and omized secondary atherosclerosis intervention trial , obtained coronary arteriograms at baseline , 3 , 5 , and 7 or 10 years of follow-up . Assessment s of changes between pairs of coronary arteriograms were made by two-member panels blinded to the patients ' assigned treatment and to the temporal sequence of the films . The relationship of changes between the baseline and the 3-year follow-up arteriograms and subsequent clinical coronary events was examined . SETTING Three university hospitals and one private primary care facility . PATIENTS A total of 838 patients , with 417 patients r and omized to the control group and 421 to the intervention group . Of all patients , 695 had baseline and 3-year arteriograms . INTERVENTION The control group received American Heart Association Phase II diet instruction and the intervention group received identical dietary instruction plus a partial ileal bypass operation . MAIN OUTCOME MEASURE The use of arteriographic changes as a predictor of subsequent clinical coronary events . RESULTS Changes between the baseline and the 3-year coronary arteriographic overall disease assessment were significantly associated with subsequent overall and atherosclerotic coronary heart disease mortality ( P less than .01 ) . For the combined end point of atherosclerotic coronary heart disease mortality or confirmed nonfatal myocardial infa rct ion , a significant relationship between the overall disease assessment and subsequent clinical events was found in the control group ( P less than .0001 ) and in the surgery group ( P = .04 ) . For this combined end point , however , the control and the surgery groups were different with respect to clinical coronary events after 3 years , stratified by the baseline to 3-year overall disease assessment ( P less than .001 , unadjusted ; P = .06 , adjusted for 3-year clinical covariates ) . CONCLUSIONS Coronary arteriographic changes can be used in atherosclerosis intervention trials as a limited surrogate end point for certain clinical coronary events . This relationship is statistically compelling for overall mortality and atherosclerotic coronary heart disease mortality . For an individual patient , changes in the severity of coronary atherosclerosis seen on sequential coronary arteriograms can serve as prognostic indicators for subsequent overall or atherosclerotic coronary heart disease mortality

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Lovastatin effects on bone mineral density in postmenopausal women with type 2 diabetes mellitus

The objective of this study was to examine the effects of lovastatin on bone mineral density ( BMD ) of postmenopausal women with type 2 diabetes mellitus ( DM ) . The study was an open-label clinical trial conducted from March 2002 to November 2003 . Fifty-five postmenopausal women age 54–67 years with type 2 DM were allocated to lovastatin-treated and control ( without lovastatin ) groups based on low-density lipoprotein cholesterol ( LDL-C ) > 130 or ≤130 mg/dl . The first group received lovastatin ( 20 mg daily titrated every 3 months to keep LDL-C less than 130 mg/dl ) for a total of 18 months . The second group received their own diabetic regimen without statin . The BMD of the lumbar spine ( L1-L4 ) , femoral neck , Wards triangle , trochanter and total hip was measured by dual-energy X-ray absorptiometry at baseline and after 18 months . In the 28 women treated with lovastatin , the BMD increased in lumbar spine ( from 0.946 ( 0.122 ) to 0.978 ( 0.135 ) g/cm2 , p<0.01 ) and Ward ’s triangle ( from 0.685 ( 0.123 ) to 0.780 ( 0.186 ) g/cm2 , p<0.01 ) . In the 27 women not treated with statin , the changes in BMD at all bone sites were not statistically significant . BMD was higher in femoral neck ( 1.2 % vs. −2.7 % , p<0.05 ) , Ward ’s triangle ( 13.9 % vs. 3.3 % , p<0.05 ) , trochanter ( −0.1 % vs. −2.9 % , p<0.05 ) , total hip ( 1.2 % vs. −1.4 % , p<0.05 ) and lumbar spine ( 3.4 % vs. 1.2 % , p>0.05 ) at the end of the study . Treatment with lovastatin may prevent bone loss in postmenopausal women with type 2 DM

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial

Objective To test the primary hypothesis that a newer antihypertensive treatment regimen ( calcium channel blocker ± an angiotensin converting enzyme inhibitor ) is more effective than an older regimen ( β-blocker ± a diuretic ) in the primary prevention of coronary heart disease ( CHD ) . To test a second primary hypothesis that a statin compared with placebo will further protect against CHD endpoints in hypertensive subjects with a total cholesterol ⩽ 6.5 mmol/l . Design Prospect i ve , r and omized , open , blinded endpoint trial with a double-blinded 2 × 2 factorial component . Setting Patients were recruited mainly from general practice s. Patients Men and women aged 40–79 were eligible if their blood pressure was ⩾160 mmHg systolic or ⩾ 100 mmHg diastolic ( untreated ) or ⩾140 mmHg systolic or ⩾ 90 mmHg diastolic ( treated ) at r and omization . Interventions Patients received either amlodipine ( 5/10 mg ) ± perindopril ( 4/8 mg ) or atenolol ( 50/100 mg ) ± bendroflumethiazide ( 1.25/2.5 mg ) + K+ with further therapy as required to reach a blood pressure of ⩽140 mmHg systolic and 90 mmHg diastolic . Patients with a total cholesterol of ⩽ 6.5 mmol/l were further r and omized to receive either atorvastatin 10 mg or placebo daily . Main outcome measure Non-fatal myocardial infa rct ion ( MI ) and fatal coronary heart disease ( CHD ) . Results 19 342 men and women were initially r and omized , of these 10 297 were also r and omized into the lipid-lowering limb . All patients had three or more additional cardiovascular risk factors . Conclusions The study has 80 % power ( at the 5 % level ) to detect a relative difference of 20 % in CHD endpoints between the calcium channel blocker-based regimen and the β-blocker-based regimen . The lipid-lowering limb of the study has 90 % power at the 1 % level to detect a relative difference of 30 % in CHD endpoints between groups

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Randomised placebo controlled trial of effect on mood of lowering cholesterol concentration

Abstract Objective : To evaluate the effects on mood of a substantial and prolonged reduction in total cholesterol concentration . Design : R and omised placebo controlled comparison of patients who had been allocated to receive simvastatin 20 mg or 40 mg daily versus those allocated matching placebo in a ratio of 2:1 . Follow up at an average of 152 weeks after r and omisation . Subjects : Men and women aged between 40 and 75 years at entry with blood total cholesterol of 3.5 mmol/l or greater , who were considered to be at higher than average risk of coronary heart disease based on medical history . Main outcome measures : The shortened profile of mood states question naire , reported use of psychotropic medication , and symptoms possibly related to mood . Results : Simvastatin reduced total cholesterol by 1.9 mmol/l ( 26.7 % ) at the time of follow up . Among all 621 patients r and omised to simvastatin ( 414 patients ) or placebo ( 207 patients ) there were no significant differences in the use of psychotropic medication or in reports of symptoms possibly related to mood . Of these patients , 491 ( 334 simvastatin , 157 placebo ) completed the mood question naire , and there were no significant differences between the treatment groups in total or subscale scores , even when patients with low baseline cholesterol concentrations or elderly subjects were considered separately . Conclusion : These results do not support the hypothesis that treatment to lower cholesterol concentration causes mood disturbance . Key messages A r and omised placebo controlled trial of simvas- tatin ( a drug that lowers cholesterol concentration substantially ) showed no associated mood distur- bance over a period of nearly three years in subjects with cardiovascular disease and no pre-existing psychiatric conditions No effects on mood were seen in individuals with low baseline cholesterol concentrations or in older individuals , and there were no differences in use of psychotropic drugs between the treatment groups These results give little support to the idea that reducing cholesterol concentration has adverse effects on

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effects of statins vs. non-statin lipid-lowering therapy on bone formation and bone mineral density biomarkers in patients with hyperlipidemia.

INTRODUCTION The 3-hydroxy-3-methylglutaryl coenzyme A ( HMG-CoA ) reductase inhibitors , named statins , are well-established cholesterol-lowering drugs able to reduce cardiovascular risk in hypercholesterolemic patients . The possible effect of statin on bone tissue , so-called pleiotropic effects has received particular attention . Studies reported a positive effect of statin on bone tissue in both of animal and human study by enhancing the expression of the bone morphogenetic proteins ( BMPs ) , in particular of BMP2 , which in turn leads to osteoblast differentiation and bone formation including interfering with osteoclastic activity . In a systematic review , the lipophilic statin as simvastatin had positive effect to bone mineral density ( BMD ) better than the more hydrophilic statin such as atorvastatin and fluvastatin . This study was aim ed to compare efficacy of medical therapy between HMG-CoA reductase inhibitor and non-HMG-CoA reductase inhibitor group to changing of bone mineral density and bone markers in the patients with hyperlipidemia . MATERIAL S AND METHODS A prospect i ve r and omized control trial study enrolled the 212 hyperlipidemia with osteopenia patients to study in year 2006 - 2008 . All subjects were r and omized to 2 groups between statin and non-statin group ; the patients were screened by inclusion criteria and measured in bone mineral density ( BMD ) , bone marker and blood chemistry . All data were analyzed by difference of changing in bone marker and BMD between statin and non-statin groups using paired t test . RESULTS The present study showed 212 hyperlipidemia with osteopenia patients of which 106 patients in statin group had mean age ( 63.17+/-9.51 years ) and the same number of patients in non-statin group had mean age ( 60.96+/-8.9 years ) . All subjects were 63 patients in male and 149 patients in female . Difference of bone formation marker and BMD between after and before was significantly higher than in statin group and the difference of bone resorption marker was also significantly lower than in statin group . CONCLUSION The lipophilic statin as moderate to high dose of simvastatin had beneficial positive effect to increasing BMD and could be additive use for prevention of bone loss in hyperlipidemia patients

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Pravastatin reduces carotid intima-media thickness progression in an asymptomatic hypercholesterolemic mediterranean population: the Carotid Atherosclerosis Italian Ultrasound Study.

PURPOSE The Carotid Atherosclerosis Italian Ultrasound Study ( CAIUS ) was performed to test the effects of lipid lowering on the progression of carotid intima-media thickness ( IMT ) in 305 asymptomatic patients from a Mediterranean country . PATIENTS AND METHODS Eligibility included hypercholesterolemia ( baseline means : low-density lipoprotein [ LDL ] = 4.68 mmol/L , high-density lipoprotein [ HDL ] = 1.37 mmol/L ) , and at least one 1.3 < IMT < 3.5 mm in the carotid arteries . Patients ( mean age 55 years , 53 % male ) were assigned to pravastatin ( 40 mg/day , n = 151 ) or placebo ( n not equal to 154 ) . Ultrasound imaging was used to quantify IMT at baseline , and semiannually thereafter for up to 3 years . The mean of the 12 maximum IMTs ( MMaxIMT ) , was calculated for each patient visit , and used to determine each patient 's longitudinal progression slope . The intention-to-treat group difference in the MMaxIMT progression was chosen a priori as the primary end point . RESULTS Five serious cardiovascular events ( 1 fatal myocardial infa rct ion ) , and 7 drop-outs for cancer were registered . In the pravastatin group , LDL decreased -0.22 after 3 months versus -0.01 in the placebo group , and remained substantially unchanged afterward ( -0.23 versus + 0.01 at 36 months , respectively ) . Progression of the MMaxIMT was 0.009 + /- 0.0027 versus -0.0043 + /- 0.0028 mm/year ( mean + /- SE , P < 0.0007 ) in the placebo and pravastatin groups , respectively . IMT progression slopes diverged after 6 months of treatment . CONCLUSIONS Pravastatin stops the progression of carotid IMT in asymptomatic , moderately hypercholesterolemic men and women . This finding extends the beneficial effects of cholesterol lowering to the primary prevention of atherosclerosis in a population with relatively low cardiovascular event rates , and suggests that this benefit is mediated by specific morphological effects on early stages of plaque development

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Tracking of high-sensitivity C-reactive protein after an initially elevated concentration: the JUPITER Study.

BACKGROUND The JUPITER ( Justification for the Use of Statins in Prevention : An Intervention Trial Evaluating Rosuvastatin ) trial suggests that increased high-sensitivity C-reactive protein ( hsCRP ) concentrations may be useful in decisions about the initiation of statin therapy for primary prevention of vascular disease . Although studies of specific population s have suggested that hsCRP is a reliable longitudinal marker , it is unclear how strongly hsCRP tracks in individuals after a single increased concentration . METHODS We evaluated tracking of hsCRP in 8901 individuals r and omized to placebo in the JUPITER trial . These individuals had screening LDL cholesterol concentrations < 130 mg/dL ( < 3.37 mmol/L ) and hsCRP concentrations > or = 2 mg/L , with subsequent hsCRP measurements made before r and omization ; at 13 weeks ; 1 , 2 , 3 , and 4 years later ; and at trial termination . Longitudinal trends and associations were evaluated nonparametrically with box plots and Spearman correlations . After data transformation to achieve normality , repeated- measures regression models estimated the intraclass correlation of hsCRP , with and without controlling for known demographic , lifestyle , and medical determinants of hsCRP concentration . For comparison , we evaluated tracking of systolic and diastolic blood pressure ; total , LDL , and HDL cholesterol ; and fasting triglycerides . RESULTS The median hsCRP concentration in these untreated individuals showed modest regression to the mean over time , declining from 3.8 mg/L at r and omization to 3.4 mg/L at 4 years . Tracking correlations for hsCRP over time were comparable to those for blood pressure and LDL cholesterol , but lower than those for HDL , fasting triglycerides , and total cholesterol . The intraclass correlation for repeated hsCRP measurements was 0.54 ( 95 % CI , 0.53 - 0.55 ) without covariate adjustment and 0.50 ( 95 % CI , 0.49 - 0.51 ) after adjustment for demographic , lifestyle , and comorbidity determinants . CONCLUSIONS Concentrations of hsCRP show strong tracking , even after selection of individuals with initially high values . Without statin therapy , increased concentrations of hsCRP generally remain high over time

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effect of pharmacologic lipid lowering on health-related quality of life in older persons: results from the Cholesterol Reduction in Seniors Program (CRISP) Pilot Study.

OBJECTIVE To determine the effect of lovastatin therapy on health-related quality of life in older persons . DESIGN A prospect i ve , r and omized , double blind clinical trial . SETTING Four university medical center research clinics . PARTICIPANTS There were 431 men and women , primarily 65 years of age or older , with low density lipoprotein levels greater than 159 mg/dL and less than 221 mg/dL. Exclusion criteria included a Mini-Mental state score less than 24 or presence of recent cardiovascular events or other serious chronic disease likely to shorten survival . INTERVENTION All participants were administered the National Cholesterol Education Program step one diet and were then r and omized to placebo , 20 mg lovastatin , or 40 mg lovastatin . MEASUREMENTS Areas of health-related quality of life assessed in the Cholesterol Reduction in Seniors Program ( CRISP ) included : ( 1 ) physical functioning , ( 2 ) sleep behavior , ( 3 ) social support , ( 4 ) depression , ( 5 ) cognitive function , and ( 6 ) health perception . Three global change questions asked the patients to judge change in general health since starting the study diet or the study medication and change in ability to function or care for self . Although some patients were followed for a total of 12 months , all participants were followed for 6 months , and 6-month data have been used for the primary analysis in this paper . RESULTS Patients treated with 20 mg of lovastatin had a 17 % and 24 % reduction in total cholesterol and LDL-cholesterol , respectively . Patients treated with the 40-mg lovastatin dose achieved reductions of 20 % for total cholesterol and 28 % for LDL-cholesterol . Complaints of possible adverse events were remarkably similar in the two active treatment groups and the placebo group . At 6 months of follow-up there were no statistically significant differences found in mean change scores from baseline between treatment groups on the health-related quality of life measures ( physical functioning , sleep , social support , depression , cognitive function scales , health perception ) or global questions . CONCLUSIONS This study demonstrates that lovastatin was extremely well tolerated in an older cohort , both with regard to symptoms and to health-related quality of life

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Low-Dose Combined Therapy with Fluvastatin and Cholestyramine in Hyperlipidemic Patients

Table . SI Units and Drugs Many reports have shown the efficacy of the combination of bile-absorbing resin and 3-hydroxy-3-methylglutaryl coenzyme A ( HMG-CoA ) reductase inhibitor ( statin class ) therapies [ 1 - 4 ] . Primarily , this resin-statin treatment regimen has been targeted to patients with low-density lipoprotein ( LDL ) cholesterol levels greater than 6.47 mmol/L ( > 250 mg/dL ) , a population presumably enriched with familial hypercholesterolemic patients . Consequently , dosages have been large , with both the statin and resin agents administered at the upper ends of their respective dosing ranges . However , this group of markedly hypercholesterolemic patients does not represent the typical person identified through the adult National Cholesterol Education Program guidelines . For the considerably larger pool of persons with LDL cholesterol between 4.14 mmol/L and 6.21 mmol/L ( 160 mg/dL and 240 mg/dL ) , a safe , convenient , well-tolerated , and effective dosing method is essential . Low-dose combination therapy is thought to be beneficial because long-term compliance is enhanced and safety maximized while efficacy is preserved . It has been suggested that side effects with statin agents are dose-dependent , thereby implying a benefit with routine use of lower dosing . In contrast , side effects attributed to resin are equivalent at varying doses within the usual dosing range [ 5 , 6 ] . Thus , the benefit of lower resin dose would be confined to enhanced palatability and tolerability . The overall cholesterol lowering with such a low-dose combination , however , still remains unknown . Fluvastatin sodium ( Lescol , S and oz ; East Hanover , New Jersey ) , a new water-soluble cholesterol-lowering agent that acts through the inhibition of HMG-CoA reductase , is the first entirely synthetic HMG-CoA reductase inhibitor and differs structurally from the fungal derivatives of compactin [ 7 ] . Fluvastatin has a distinctive biopharmaceutical profile ; it has a high rate of absorption that is not influenced by food intake , possesses no circulating active metabolites , is 98 % protein-bound , does not cross the blood-brain barrier , has a systemic half-life of 30 minutes , and is 95 % excreted by the liver [ 8 ] . We evaluated the LDL cholesterol-lowering efficacy of various combinations of low-dose resin and statin treatments , using cholestyramine ( Questran Light ; Bristol ) and fluvastatin . The study population included mostly patients with hypercholesterolemia who would , according to the new National Cholesterol Education Program guidelines for adults ( LDL cholesterol > 4.91 mmol/L [ > 190 mg/dL ] or LDL cholesterol > 4.14 mmol/L [ > 160 mg/dL ] with two risk factors ) , be advised to receive medication . Methods The study protocol was design ed by mutual consent of the investigators and S and oz Research Institute , with all data collected by the investigators subject to review and analysis by S and oz Research Institute . The interpretation of the data in this article is based on the mutual consent of all su bmi tting authors . All patients were consecutively r and omized based on a diagnosis of hypercholesterolemia confirmed during drug washout with an LDL cholesterol level of at least 4.14 mmol/L ( 160 mg/dL ) , despite dietary intervention , and a plasma triglyceride level of no more than 3.39 mmol/L ( 300 mg/dL ) . Persons were excluded if they had a history of homozygous familial hypercholesterolemia , secondary hyperlipidemia , liver disease , renal disease , diabetes , myocardial infa rct ion or angioplasty within 6 months of study entry , or uncontrolled hypertension . The patients ' mean age was 54.1 years ; 54 % were male ; 95 % were white and 3 % were black . The treatment groups did not differ in baseline demographic characteristics . The study was approved by the institutional review boards for human research of all participating institutions . Informed consent was obtained from all patients . Treatment Plan This study consisted of a 6-week , single-blind , placebo washout period followed by a 24-week , double-blind treatment period divided into three phases ( Figure 1 ) . Patients were withdrawn from hypolipidemic therapy for at least 4 weeks ( 1 year for probucol ) before entry into the washout period . In addition , patients were instructed by a registered dietitian to follow a cholesterol-lowering diet ( American Heart Association or National Cholesterol Education Program step 1 ) for at least 8 weeks before entry into the washout period and throughout the study , and a Food Record Rating score of 15 or less was required for study entry [ 9 ] . Patients with aspartate aminotransferase or alanine aminotransferase values greater than 1.5 times the upper limit of laboratory normal during the washout period were excluded from the study . Figure 1 . Study design and numbers of patients initially assigned to each treatment group . At the end of the placebo washout period , patients who satisfied all entry criteria entered the 24-week , double-blind treatment period , which consisted of three 8-week phases . For the first 8 weeks ( phase 1 ) , patients were assigned r and omly into six groups receiving blinded study medication : two groups receiving placebo ; two receiving 10 mg of fluvastatin ; and two receiving 20 mg of fluvastatin . In phases 2 and 3 of the study , one placebo group , one 10-mg fluvastatin group , and one 20-mg fluvastatin group received open-label cholestyramine in addition to the blinded study drug , whereas the other three groups remained on fluvastatin or placebo monotherapy for the rest of the trial . In phase 2 , the dose of cholestyramine added to the regimen of patients in the three combination groups was 4 g twice daily . In phase 3 , the dose of cholestyramine was increased to 8 g twice a day for these patients . Blinded medication was taken once daily at bedtime , approximately 4 hours after the evening meal . Patients receiving open-label cholestyramine took their medication just before breakfast and dinner . Compliance with all treatment regimens was assessed by pill or packet count . Study Evaluations Patients were assessed every 2 weeks during the placebo washout period and every 4 weeks during the 24-week treatment period . Dietary compliance was determined by Food Record Rating scores derived from dietary records collected throughout the study [ 9 ] . Twelve-hour fasting blood sample s were obtained at each visit for lipid determinations , which were done by a central laboratory ( Medical Research Laboratories ; Cincinnati , Ohio ) . Low-density lipoprotein cholesterol was calculated according to the Friedewald formula [ 10 ] . Total cholesterol , high-density lipoprotein cholesterol , and plasma triglycerides were measured on a 737 Hitachi analyzer ( Boehringer Mannheim Diagnostics ; Indianapolis , Indiana ) with microenzymatic procedures [ 11 ] fully st and ardized , and part 3 was monitored through the National Heart , Lung , and Blood Institute and Centers for Disease Control and Prevention Lipid St and ardization Program [ 12 , 13 ] . Safety was evaluated at baseline and at intervals throughout the study . These evaluations included measurements of blood pressure and pulse ; physical , ophthalmologic , and electrocardiographic examinations ; and routine laboratory tests . Investigators were asked to assess , in a blinded fashion , each adverse event and laboratory abnormality for a potential relation to blinded study drug administration , based on their clinical experience and judgment . Statistical Analysis All statistical comparisons were made using two-tailed tests at the P < 0.05 level . Data were pooled across all clinical centers for analysis . The Statistical Analysis System ( SAS Institute , Inc. ; Cary , North Carolina ) software was used for all analyses . All confidence intervals are 95 % and represent the difference in mean percent change from baseline between two treatment groups of interest . For each patient , the baseline lipid value was defined as the average of the week 2 and week 0 lipid measurements during the washout phase . In evaluating efficacy by treatment phase , lipid results were calculated as the averages of the values for weeks 4 and 8 , weeks 12 and 16 , and weeks 20 and 24 . For end-point analyses , the end point was defined as the last active treatment phase visit for which lipid data were available . One-way analysis of variance models were used to compare the mean percentage change in total cholesterol , LDL cholesterol , high-density lipoprotein cholesterol , and triglycerides between the treatment groups . In each model , we did tests of significance of the percentage change from baseline within each group and of differences in mean percentage change between treatment groups . In determining safety , a newly occurring abnormality was defined as an abnormality reported during the active treatment period but not reported during the placebo washout period , and a worsening abnormality was an abnormality that worsened from the placebo washout period to the active treatment period . The number of patients with newly occurring or worsening abnormalities in each treatment group was determined , and the proportions were compared using the Fisher exact test . Results Of 460 patients from nine study centers screened , 224 met study criteria and were r and omized into the double-blind treatment period of this study ; 203 completed all phases of treatment . Fifteen ( 10 % ) of 150 fluvastatin-treated patients and 6 ( 8 % ) of 74 placebo- or cholestyramine-treated or both ( that is , non-fluvastatin-treated ) patients were dropped during the double-blind treatment period . Five fluvastatin-treated patients ( 1 receiving concomitant cholestyramine ) and 1 placebo-treated patient ( receiving concomitant cholestyramine ) dropped out because of adverse events . These events , each of which occurred in one patient , were angina , myalgia , stomatitis and glossitis , heartburn and indigestion , elevated transaminase levels , and alopecia . Of these , only the instance of stomatitis and glossitis was judged by the investigator to be definitely related to the drug . One patient

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Low-Dose Metoprolol CR/XL and Fluvastatin Slow Progression of Carotid Intima-Media Thickness: Main Results From the &bgr;-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS)

Background Statins reduce cardiovascular events and progression of carotid intima-media thickness ( IMT ) . & bgr;-Blockers are also known to reduce cardiovascular events , but less is known about their effects on carotid IMT . Methods and Results We conducted a r and omized , double-blind , placebo-controlled , single-center trial to compare the effects of low-dose metoprolol CR/XL ( 25 mg once daily ) and fluvastatin ( 40 mg once daily ) on the progression of carotid IMT during 36 months of treatment in 793 subjects who had carotid plaque but no symptoms of carotid artery disease . Changes in mean IMT in the common carotid artery and maximal IMT in the bulb were the main outcome variables . Death and cardiovascular events were monitored . Progression of IMTmax in the carotid bulb at both 18 and 36 months was reduced by metoprolol CR/XL ( −0.058 mm/y ; 95 % CI , −0.094 to −0.023;P = 0.004 ; and −0.023 mm/y ; 95 % CI , −0.044 to −0.003;P = 0.014 , respectively ) . Incidence of cardiovascular events tended to be lower in metoprolol CR/XL – treated patients ( 5 versus 13 patients , P = 0.055 ) . Rate of IMTmean progression in the common carotid at 36 months was reduced by fluvastatin ( −0.009 mm/y ; 95 % CI , −0.015 to −0.003;P = 0.002 ) . Women in the fluvastatin group had increased frequency of transiently high liver enzymes . Conclusions This is the first r and omized trial to show that a & bgr;-blocker can reduce the rate of progression of carotid IMT in clinical ly healthy , symptom-free subjects with carotid plaque . This suggests that & bgr;-blockers may have a favorable effect on atherosclerosis development

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Changes in cardiovascular risk factors by combined pharmacological and nonpharmacological strategies: the main results of the CELL Study.

OBJECTIVE The objectives of the Cost Effectiveness of Lipid Lowering ( CELL ) study were twofold : ( i ) to evaluate the effect on overall cardiovascular risk of two types of health care advice ( " usual ' and " intensive ' ) given in primary care , with or without pharmacological medication , with the target being to attain a moderate decrease in cholesterol ; ( ii ) to evaluate the ritual of daily medication on compliance with the health care advice . DESIGN A prospect i ve , double-blind , r and omized , controlled trial of 18 months ' duration . SETTING The study was carried out in 32 health centres ( out of a total of approximately 850 ) in Sweden . SUBJECTS In all , 681 subjects , aged 30 - 59 years , were r and omized . They had at least two cardiovascular risk factors in addition to moderate primary hyperlipidaemia ( total cholesterol of at least 6.50 mmol L-1 on three occasions measured by Reflotron triglycerides less than 4.0 mmol L-1 and an LDL : HDL cholesterol ratio of more than 4.0 ) . Most ( 87 % ) of the subjects were males ; 626 subjects ( 92 % ) completed the 18-month follow-up . INTERVENTION Half the subjects were r and omized to ' intensive advice ' given in group sessions led by doctors and nurses in primary care . The other half received ' usual advice ' . In each of the two advice groups , one-third received an active lipid-lowering drug ( pravastatin ) , one-third placebo , and one-third no drug at all . The tablets were titrated to achieve a 15 % reduction in cholesterol . MAIN OUTCOME MEASURES Changes in the overall Framingham risk score , and the development of adverse events in each group . RESULTS The change in Framingham risk score was significantly reduced only in subjects taking lipid-lowering medication ( together with intensive advice -0.13 ; 95 % CI-0.20 , -0.06 , and together with usual advice -0.16 ; 95 % CI -0.23 , -0.09 ) . The other subjects receiving intensive advice tended to fare better than those on usual advice . Lifestyle was not influenced significantly over the study period . The ritual of daily medication did not affect the outcome . CONCLUSION As expected , lipid-lowering medication reduced serum cholesterol as well as overall cardiovascular risk in subjects with several risk factors for cardiovascular disease . There was no additive effect of intensive advice to these subjects . However , there was a meagre but significant effect of intensive advice in subjects not receiving active lipid-lowering drugs . One explanation for this difference may be that those on active lipid-lowering medication who had substantial drops in cholesterol might have felt less inclined to change their lifestyle compared with those on other treatment regimens who had less successful drops in cholesterol . There was no benefit from the ritual of taking daily medication

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Design of the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with type 2 diabetes.

BACKGROUND There are few data on the role of lipid lowering in the primary prevention of coronary heart disease ( CHD ) in diabetic patients . This paper describes the design of a collaborative clinical trial between Diabetes UK , the NHS Research and Development Directorate and Pfizer UK , that addresses this question . METHODS The Collaborative AtoRvastatin Diabetes Study ( CARDS ) is a multicentre , r and omized , placebo-controlled , double-blind clinical trial of primary prevention of cardiovascular disease in patients with Type 2 diabetes . The primary objective is to investigate whether treatment with the hydroxymethylglutaryl coenzyme A reductase inhibitor , atorvastatin , reduces the incidence of major cardiovascular events . At entry patients have at least one other risk factor for CHD in addition to diabetes , namely current smoking , hypertension , retinopathy , or micro- or macroalbuminuria . At r and omization patients have been selected for a serum low-density lipoprotein ( LDL ) cholesterol concentration < or = 4.14 mmol/l ( 160 mg/dl ) and triglycerides < or = 6.78 mmol/l ( 600 mg/dl ) . R and omization was completed in June 2001 . Patients will be followed until 304 primary endpoints have accrued ( expected date early 2005 ) . The trial includes 2838 men and women aged 40 - 75 years . This report describes the design and administration of the study and review s the evidence to date of the effectiveness of lipid-lowering therapy in Type 2 diabetes . CONCLUSIONS The case for lipid-lowering therapy for the primary prevention of CHD in diabetes has not been demonstrated . CARDS will provide essential information on the extent of any benefits and adverse effects of lipid-lowering therapy in diabetic patients without prior CHD

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion.

BACKGROUND Patients with coronary artery disease and abnormalities of serum lipids often have endothelial vasodilator dysfunction , which may contribute to ischemic cardiac events . Whether cholesterol-lowering or antioxidant therapy can restore endothelium-dependent coronary vasodilation is unknown . METHODS We r and omly assigned 49 patients ( mean serum cholesterol level , 209 + /- 33 mg per deciliter [ 5.40 + /- 0.85 mmol per liter ] ) to receive one of three treatments : an American Heart Association Step 1 diet ( the diet group , 11 patients ) ; lovastatin and cholestyramine ( the low-density lipoprotein [LDL]-lowering group , 21 patients ) ; or lovastatin and probucol ( the LDL-lowering-antioxidant group , 17 patients ) . Endothelium-dependent coronary-artery vasomotion in response to an intracoronary infusion of acetylcholine ( 10(-8 ) to 10(-6 ) M ) was assessed at base line and after one year of therapy . Vasoconstrictor responses to these doses of acetylcholine are considered to be abnormal . RESULTS Treatment result ed in significant reductions in LDL cholesterol levels of 41 + /- 22 percent in the LDL-lowering-antioxidant group and 38 + /- 20 percent in the LDL-lowering group ( P < 0.001 vs. the diet group ) . The maximal changes in coronary-artery diameter with acetylcholine at base line and at follow-up were -19 and -2 percent , respectively , in the LDL-lowering-antioxidant group , -15 and -6 percent in the LDL-lowering group , and -14 and -19 percent in the diet group ( P < 0.01 for the LDL-lowering-antioxidant group vs. the diet group ; P = 0.08 for the LDL-lowering group vs. the diet group ) . ( The negative numbers indicate vasoconstriction ) . Thus , the greatest improvement in the vasoconstrictor response was seen in the LDL-lowering-antioxidant group . CONCLUSIONS The improvement in endothelium-dependent vasomotion with cholesterol-lowering and antioxidant therapy may have important implication s for the activity of myocardial ischemia and may explain in part the reduced incidence of adverse coronary events that is known to result from cholesterol-lowering therapy

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Comparative dose efficacy study of atorvastatin versus simvastatin, pravastatin, lovastatin, and fluvastatin in patients with hypercholesterolemia (the CURVES study)

The objective of this multicenter , r and omized , open-label , parallel-group , 8-week study was to evaluate the comparative dose efficacy of the 3-hydroxy-3-methylglutaryl coenzyme A ( HMG-CoA ) reductase inhibitor atorvastatin 10 , 20 , 40 , and 80 mg compared with simvastatin 10 , 20 , and 40 mg , pravastatin 10 , 20 , and 40 mg , lovastatin 20 , 40 , and 80 mg , and fluvastatin 20 and 40 mg . Investigators enrolled 534 hypercholesterolemic patients ( low-density lipoprotein [ LDL ] cholesterol > or = 160 mg/dl [ 4.2 mmol/L ] and triglycerides < or = 400 mg/dl [ 4.5 mmol/L ] ) . The efficacy end points were mean percent change in plasma LDL cholesterol ( primary ) , total cholesterol , triglycerides , and high-density lipoprotein cholesterol concentrations from baseline to the end of treatment ( week 8) . Atorvastatin 10 , 20 , and 40 mg produced greater ( p < or = 0.01 ) reductions in LDL cholesterol , -38 % , -46 % , and -51 % , respectively , than the milligram equivalent doses of simvastatin , pravastatin , lovastatin , and fluvastatin . Atorvastatin 10 mg produced LDL cholesterol reductions comparable to or greater than ( p < or = 0.02 ) simvastatin 10 , 20 , and 40 mg , pravastatin 10 , 20 , and 40 mg , lovastatin 20 and 40 mg , and fluvastatin 20 and 40 mg . Atorvastatin 10 , 20 , and 40 mg produced greater ( p < or = 0.01 ) reductions in total cholesterol than the milligram equivalent doses of simvastatin , pravastatin , lovastatin , and fluvastatin . All reductase inhibitors studied had similar tolerability . There were no incidences of persistent elevations in serum transaminases or myositis

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial

BACKGROUND Statins lower high-sensitivity C-reactive protein ( hsCRP ) and cholesterol concentrations , and hypothesis generating analyses suggest that clinical outcomes improve in patients given statins who achieve hsCRP concentrations less than 2 mg/L in addition to LDL cholesterol less than 1.8 mmol/L ( < 70 mg/dL ) . However , the benefit of lowering both LDL cholesterol and hsCRP after the start of statin therapy is controversial . We prospect ively tested this hypothesis . METHODS In an analysis of 15 548 initially healthy men and women participating in the JUPITER trial ( 87 % of full cohort ) , we prospect ively assessed the effects of rosuvastatin 20 mg versus placebo on rates of non-fatal myocardial infa rct ion , non-fatal stroke , admission for unstable angina , arterial revascularisation , or cardiovascular death ( prespecified endpoints ) during a maximum follow-up of 5 years ( median 1.9 years ) , according to on-treatment concentrations of LDL cholesterol ( > /=1.8 mmol/L or < 1.8 mmol/L ) and hsCRP ( > /=2 mg/L or < 2 mg/L ) . We included all events occurring after r and omisation . This trial is registered with Clinical Trials.gov , number NCT00239681 . FINDINGS Compared with placebo , participants allocated to rosuvastatin who achieved LDL cholesterol less than 1.8 mmol/L had a 55 % reduction in vascular events ( event rate 1.11 vs 0.51 per 100 person-years ; hazard ratio [ HR ] 0.45 , 95 % CI 0.34 - 0.60 , p<0.0001 ) , and those achieving hsCRP less than 2 mg/L a 62 % reduction ( event rate 0.42 per 100 person-years ; HR 0.38 , 95 % CI 0.26 - 0.56 , p<0.0001 ) . Although LDL cholesterol and hsCRP reductions were only weakly correlated in individual patients ( r values < 0.15 ) , we recorded a 65 % reduction in vascular events in participants allocated to rosuvastatin who achieved both LDL cholesterol less than 1.8 mmol/L and hsCRP less than 2 mg/L ( event rate 0.38 per 100 person-years ; adjusted HR 0.35 , 95 % CI 0.23 - 0.54 ) , versus a 33 % reduction in those who achieved one or neither target ( event rate 0.74 per 100 person-years ; HR 0.67 , 95 % CI 0.52 - 0.87 ) ( p across treatment groups < 0.0001 ) . In participants who achieved LDL cholesterol less than 1.8 mmol/L and hsCRP less than 1 mg/L , we noted a 79 % reduction ( event rate 0.24 per 100 person-years ; HR 0.21 , 95 % CI 0.09 - 0.52 ) . Achieved hsCRP concentrations were predictive of event rates irrespective of the lipid endpoint used , including the apolipoprotein B to apolipoprotein AI ratio . INTERPRETATION For people choosing to start pharmacological prophylaxis , reduction in both LDL cholesterol and hsCRP are indicators of successful treatment with rosuvastatin

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

The CARDS trial: Diabetic patients dealt a winning hand

Until recently , the role of statin therapy in diabetic patients without clinical signs or symptoms of coronary heart disease had been inadequately defined . The Collaborative Atorvastatin Diabetes Study ( CARDS ) is a prospect i ve , r and omized , placebo-controlled trial design ed to compare the effects of atorvastatin with placebo in preventing primary coronary events in diabetic patients . After a median of only 3.9 years ( the study was terminated approximately 2 years early due to the magnitude of benefit attributable to atorvastatin therapy ) , risk for major cardiovascular events was decreased by 37 % , acute coronary heart disease-related events were also reduced by 36 % , coronary revascularizations by 31 % , and stroke by 48 % . Benefit emerged within 1 year of initiating therapy

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effects of probucol and pravastatin on common carotid atherosclerosis in patients with asymptomatic hypercholesterolemia. Fukuoka Atherosclerosis Trial (FAST).

OBJECTIVES This study investigated the effect of reducing serum lipids on carotid artery intima-media thickness ( IMT ) in asymptomatic patients with hypercholesterolemia from Fukuoka , Japan . BACKGROUND Carotid atherosclerosis is a strong , independent predictor of morbidity and mortality in patients with coronary heart disease ( CHD ) . METHODS A total of 246 asymptomatic hypercholesterolemic patients ( mean age 66 years ) were r and omized to receive either probucol ( 500 mg/day , n = 82 ) or pravastatin ( 10 mg/day , n = 83 ) or to enter a control group ( diet alone , n = 81 ) ; they were followed for two years . The change in IMT in the common carotid artery was the primary end point measure , and the incidence of major cardiovascular events was the secondary measure . RESULTS Over the two-year period , serum low-density lipoprotein ( LDL ) cholesterol was significantly reduced in the pravastatin group ( 36 % ) , the probucol group ( 29 % ) and the control group ( 12 % ) ( p < 0.0001 , p < 0.0001 and p < 0.05 , respectively ) . After two years , the probucol and pravastatin groups showed a significant reduction in IMT ( -13.9 % and -13.9 % and p < 0.01 and p < 0.01 , respectively ) , but there was significant IMT thickening ( 23.2 % ; p < 0.05 ) in the control group . Probucol reduced the rate of IMT increase , independently of its reduction of LDL or high-density lipoprotein cholesterol . Moreover , there was a significantly lower incidence of cardiac events in the probucol group ( 2.4 % ) than in the control group ( 13.6 % ) ( p = 0.0136 ) . CONCLUSIONS Probucol reduced cholesterol levels and stabilized plaque , leading to a lower incidence of cardiac events in these hypercholesterolemic patients

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Compliance and adverse event withdrawal: their impact on the West of Scotland Coronary Prevention Study.

AIMS To assess the additional benefit gained from high compliance in the West of Scotl and Coronary Prevention Study and to examine cases where withdrawal from trial medication was due to an adverse event . METHODS The incidence of definite coronary heart disease or non-fatal myocardial infa rct ion , cardiovascular mortality , definite or suspect coronary heart disease death or non-fatal myocardial infa rct ion , the need for coronary revascularization procedures , all-cause mortality and incident cancers were measured in the entire cohort and compared with the high compliance group . The adverse events associated with withdrawal were coded by body system . RESULTS In subjects with compliance > or = 75 % , treatment with pravastatin result ed in a 38 % risk reduction for definite coronary heart disease death or non-fatal myocardial infa rct ion and for cardiovascular mortality , a 46 % reduction in risk or coronary revascularization and a 32 % risk reduction ( P = 0.015 ) for all-cause mortality . CONCLUSIONS The analysis of the effect of pravastatin in the subgroup of high compliers to r and omized medication demonstrated a substantial increase in the estimated risk reductions in comparison with that achieved in the intention-to-treat analysis . This result has significant implication s for the motivation of high compliance among patients and for the assessment of the cost-effectiveness of treatment

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Atorvastatin normalizes endothelial function in healthy smokers.

Endothelial function is known to predict cardiovascular disease . The aim of the present study was to examine whether endothelial function in smokers with normal cholesterol levels could be normalized by treatment with 80 mg of atorvastatin in comparison with a control group . Healthy smokers ( n=20 ) and non-smokers ( n=20 ) were r and omized to receive 80 mg of atorvastatin or placebo in an open r and omized cross-over study , followed by measurement of endothelial functional [ FMD ( flow-mediated dilation ) ] . At baseline , smokers had a lower FMD compared with the non-smoking group ( 2.2+/-0.5 and 4.5+/-0.8 % respectively ; P<0.05 ) . In the smoking group , FMD increased significantly ( P<0.05 ) to 4.0+/-0.8 % during treatment with atorvastatin and returned to basal levels during placebo ( 2.3+/-0.6 % ) . In the non-smoking group , FMD was unaffected by both atorvastatin and placebo . The net change of total cholesterol or LDL ( low-density lipoprotein)-cholesterol was not associated with the net change in FMD when the study group was considered as a whole or the smoking group was considered separately . In conclusion , improved endothelial function was observed in a group of smokers when they were received 80 mg of atorvastatin , whereas atorvastatin had no effect on endothelial function in the non-smoking group . The improved FMD among smokers was independent of the decrease in LDL-cholesterol during atorvastatin treatment . The results show that poor endothelial function in smokers with normal lipid levels can be improved by a statin treatment

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT).

CONTEXT Studies have demonstrated that statins administered to individuals with risk factors for coronary heart disease ( CHD ) reduce CHD events . However , many of these studies were too small to assess all-cause mortality or outcomes in important subgroups . OBJECTIVE To determine whether pravastatin compared with usual care reduces all-cause mortality in older , moderately hypercholesterolemic , hypertensive participants with at least 1 additional CHD risk factor . DESIGN AND SETTING Multicenter ( 513 primarily community-based North American clinical centers ) , r and omized , nonblinded trial conducted from 1994 through March 2002 in a subset of participants from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial ( ALLHAT ) . PARTICIPANTS Ambulatory persons ( n = 10 355 ) , aged 55 years or older , with low-density lipoprotein cholesterol ( LDL-C ) of 120 to 189 mg/dL ( 100 to 129 mg/dL if known CHD ) and triglycerides lower than 350 mg/dL , were r and omized to pravastatin ( n = 5170 ) or to usual care ( n = 5185 ) . Baseline mean total cholesterol was 224 mg/dL ; LDL-C , 146 mg/dL ; high-density lipoprotein cholesterol , 48 mg/dL ; and triglycerides , 152 mg/dL. Mean age was 66 years , 49 % were women , 38 % black and 23 % Hispanic , 14 % had a history of CHD , and 35 % had type 2 diabetes . INTERVENTION Pravastatin , 40 mg/d , vs usual care . MAIN OUTCOME MEASURES The primary outcome was all-cause mortality , with follow-up for up to 8 years . Secondary outcomes included nonfatal myocardial infa rct ion or fatal CHD ( CHD events ) combined , cause-specific mortality , and cancer . RESULTS Mean follow-up was 4.8 years . During the trial , 32 % of usual care participants with and 29 % without CHD started taking lipid-lowering drugs . At year 4 , total cholesterol levels were reduced by 17 % with pravastatin vs 8 % with usual care ; among the r and om sample who had LDL-C levels assessed , levels were reduced by 28 % with pravastatin vs 11 % with usual care . All-cause mortality was similar for the 2 groups ( relative risk [ RR ] , 0.99 ; 95 % confidence interval [ CI ] , 0.89 - 1.11 ; P = .88 ) , with 6-year mortality rates of 14.9 % for pravastatin vs 15.3 % with usual care . CHD event rates were not significantly different between the groups ( RR , 0.91 ; 95 % CI , 0.79 - 1.04 ; P = .16 ) , with 6-year CHD event rates of 9.3 % for pravastatin and 10.4 % for usual care . CONCLUSIONS Pravastatin did not reduce either all-cause mortality or CHD significantly when compared with usual care in older participants with well-controlled hypertension and moderately elevated LDL-C. The results may be due to the modest differential in total cholesterol ( 9.6 % ) and LDL-C ( 16.7 % ) between pravastatin and usual care compared with prior statin trials supporting cardiovascular disease prevention

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Comparison of one-year efficacy and safety of atorvastatin versus lovastatin in primary hypercholesterolemia. Atorvastatin Study Group I.

This double-blind study to evaluate long-term efficacy and safety of atorvastatin was performed in 31 community- and university-based research centers in the USA to directly compare a new 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor ( reductase inhibitor ) to an accepted drug of this class in patients with moderate hypercholesterolemia . Participants remained on a cholesterol-lowering diet throughout the study . One thous and forty-nine patients were r and omized to receive atorvastatin 10 mg , lovastatin 20 mg , or placebo . At 16 weeks the placebo group was r and omized to either atorvastatin or lovastatin treatment . At 22 weeks , patients who had not met low-density lipoprotein ( LDL ) cholesterol target levels doubled the dose of reductase inhibitor . Efficacy evaluation was mean percent change from baseline in LDL cholesterol , triglycerides , total cholesterol , high-density-lipoprotein cholesterol , and apolipoprotein B ( apoB ) . Safety profiles as determined by change from baseline in laboratory evaluations , ophthalmologic parameters , and reporting of adverse events were similar for the 2 reductase inhibitors . After 52 weeks , the atorvastatin group maintained a significantly greater reduction in LDL cholesterol ( -37 % vs -29 % ) , triglyceride ( -16 % vs -8 % ) , total cholesterol ( -27 % vs -21 % ) , and apoB ( -30 % vs -22 % ) ( p < 0.05 ) . More patients receiving atorvastatin achieved LDL cholesterol target levels than did lovastatin patients ( 78 % vs 63 % , respectively ) , particularly those with coronary heart disease ( 37 % vs 11 % , respectively ) . Atorvastatin is highly effective and well tolerated in patients with primary hypercholesterolemia with no increased risk of adverse events

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effects of bezafibrate and of 2 HMG-CoA reductase inhibitors on lipoprotein (a) level in hypercholesterolemic patients.

Lp(a ) level is relatively stable in each individual and is mainly under genetic control . Attempts made to lower Lp(a ) with pharmacological means gave conflicting results . In order to further evaluate the effect of hypocholesterolemic drugs on Lp(a ) level , 66 patients with primary hypercholesterolemia were selected . The vast majority of the patients had Lp(a ) concentration at the low end of the range of distribution , 7 had undetectable Lp(a ) levels and only 2 had Lp(a ) higher than 30 mg/dl . No relationship was found between Lp(a ) level and serum and lipoprotein lipids . In 12 patients serum cholesterol was well controlled by diet alone and the patients continued the diet for up to 8 months . The other patients were r and omly subdivided into 3 groups of therapy . The first group received slow release bezafibrate 400 mg once a day , the second one pravastatin 20 mg once a day and the third one simvastatin 10 - 40 mg once a day . Drug therapy lasted for 8 months . At the end of the period , 22 of 29 patients treated with the 2 HMG-CoA reductase inhibitors had Lp(a ) higher than baseline . The difference was statistically significant in both groups of patients . No significant change in Lp(a ) was observed in diet and in bezafibrate group . Serum and LDL cholesterol significantly decreased in all the 3 drug groups . The increase in Lp(a ) after the 2 HMG-CoA reductase was small enough to have negligible effects on cardiovascular risk , but raises the problem of the role of LDL receptor in the catabolism of Lp(a )

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Long-term effects of pravastatin and fosinopril on peripheral endothelial function in albuminuric subjects.

The purpose of this double-blind , r and omized , placebo-controlled trial was to determine the long-term effects of pravastatin and fosinopril treatment on peripheral endothelial function in subjects with albuminuria . Subjects ( mean age 51 years , 63 % male ) were r and omized to pravastatin 40 mg or matching placebo and to fosinopril 20 mg or matching placebo . Using high resolution ultrasound , flow-mediated dilation ( FMD ) and nitroglycerin-induced dilation ( NID ) was assessed at baseline and after 4 years of treatment in a total of 276 subjects . At baseline , mean+/-st and ard error FMD was 4.73+/-0.49 % and NID was 10.86+/-0.67 % . Pravastatin significantly reduced total cholesterol and LDL cholesterol ( p<0.01 ) and r and omization to pravastatin was associated with a non-significant improvement of 18.9 % in FMD ( + 0.80+/-0.95 , p=0.09 ) , without a significant change in NID . Interestingly , pravastatin significantly increased FMD by 34.9 % in men ( + 1.23 , p=0.04 ) , but only 1.1 % in women ( + 0.06 , p=0.95 ) . Fosinopril was not associated with a change in FMD or NID despite significantly decreasing urinary albumin excretion , systolic and diastolic blood pressure ( all p<0.01 ) . In conclusion , after 4 years of follow-up , pravastatin treatment tended to increase FMD and this effect was predominantly present in men . Fosinopril treatment did not modify FMD during long-term follow-up

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Different Effects of Antihypertensive Regimens Based on Fosinopril or Hydrochlorothiazide With or Without Lipid Lowering by Pravastatin on Progression of Asymptomatic Carotid Atherosclerosis: Principal Results of PHYLLIS—A Randomized Double-Blind Trial

Background and Purpose — The Plaque Hypertension Lipid-Lowering Italian Study ( PHYLLIS ) tested whether ( 1 ) the angiotensin-converting enzyme ( ACE ) inhibitor fosinopril ( 20 mg per day ) was more effective on carotid atherosclerosis progression than the diuretic hydrochlorothiazide ( 25 mg per day ) , ( 2 ) pravastatin ( 40 mg per day ) was more effective than placebo when added to either hydrochlorothiazide or fosinopril , and ( 3 ) there were additive effects of ACE inhibitor and lipid-lowering therapies . Methods — A total of 508 hypertensive , hypercholesterolemic patients with asymptomatic carotid atherosclerosis were r and omized to : ( A ) hydrochlorothiazide ; ( B ) fosinopril ; ( C ) hydrochlorothiazide plus pravastatin ; and ( D ) fosinopril plus pravastatin , and followed up blindly for 2.6 years . B-Mode carotid scans were performed yearly by certified sonographers in 13 hospitals and read central ly . Corrections for drift were calculated from readings repeated at study end . Primary outcome was change in mean maximum intima-media thickness of far and near walls of common carotids and bifurcations bilaterally ( CBMmax ) . Results — CBMmax significantly progressed ( 0.010±0.004 mm per year ; P=0.01 ) in group A ( hydrochlorothiazide alone ) but not in groups B , C , and D. CBMmax changes in groups B , C , and D were significantly different from changes in group A. Changes in group A were concentrated at the bifurcations . “ Clinic ” and “ ambulatory ” blood pressure reductions were not significantly different between groups , but total and low-density lipoprotein cholesterol decreased by ≈1 mmol/L in groups C and D. Conclusions — Progression of carotid atherosclerosis occurred with hydrochlorothiazide but not with fosinopril . Progression could also be avoided by associating pravastatin with hydrochlorothiazide

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

The risks of a new hypothesis: why did JUPITER patients have almost twice the predicted event rate of reduction?

High serum cholesterol levels are associated with death from coronary heart disease and statin therapy has been demonstrated to effectively lower low-density lipoprotein ( LDL ) cholesterol and reduce coronary events in broad sections of the population . Recently , the Justification for the Use of Statins in Primary Prevention : an Intervention Trial Evaluating Rosuvastatin ( JUPITER ) r and omized 17 802 apparently healthy individuals , with levels of LDL cholesterol below current treatment thresholds but with elevated levels of high-sensitivity C-reactive protein , to rosuvastatin 20 mg daily , or placebo . At a median follow-up of almost 2 years , compared to placebo , rosuvastatin treatment was associated with a significant reduction in the incidence of major cardiovascular or cerebrovascular events , that is , almost twice the magnitude found in previous statin trials . Such a noteworthy finding is discussed herein

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Expanded Clinical Evaluation of Lovastatin (EXCEL) study results: two-year efficacy and safety follow-up.

The Exp and ed Clinical Evaluation of Lovastatin study , a r and omized , double-blind , placebo- and diet-controlled multicenter trial , evaluated the efficacy and tolerability of lovastatin over 48 weeks in 8,245 patients with moderately severe hypercholesterolemia . During year 1 of follow-up of the full cohort , lovastatin at 20 or 40 mg/day , or 20 or 40 mg twice daily , produced dose-dependent decreases in low-density lipoprotein ( LDL ) cholesterol ( 24 % to 40 % ) and triglyceride levels ( 10 % to 19 % ) , and increases in high-density lipoprotein ( HDL ) cholesterol ( 6.6 % to 9.5 % ) . In all , 977 patients continued their original blinded treatment for an additional year . In year 2 , the LDL cholesterol response to lovastatin was maintained , the triglyceride reductions were somewhat less , and the increases in HDL cholesterol were moderately greater than in year 1 . Successive transaminase elevations > 3 times the upper limit of normal were observed in only 1 patient in year 2 , yielding a cumulative 2-year incidence of from 0.1 % ( placebo or lovastatin 20 mg/day ) to 1.9 % ( lovastatin 80 mg/day ) . Myopathy occurred in only 1 patient during year 2 , and over the 2-year study was observed rarely and only at lovastatin dosages of 40 and 80 mg/day . This study indicates that lovastatin maintains its efficacy over long-term follow-up , particularly in effectively lowering LDL cholesterol , is generally well tolerated , and has a favorable safety profile

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effect of Atorvastatin on Progression of Sensorineural Hearing Loss and Tinnitus in the Elderly: Results of a Prospective, Randomized, Double-Blind Clinical Trial

Objective : To test whether the 3-hydroxy-3-methylglutaryl- coenzyme A reductase inhibitor atorvastatin can slow down the progression of presbycusis . Patients : Fifty patients 60- to 75-years-old with presbycusis and moderately elevated serum cholesterol . Intervention(s ) : In a double-blind design , patients were r and omly assigned to treatment with either atorvastatin ( 40 mg/d orally ) or placebo . Main Outcome Measure(s ) : Pure-tone audiometry and tinnitus evaluation at enrolment and after 7 and 13 months . Results : Development of hearing thresholds after 7 and 13 months showed no significant differences between the groups . Tinnitus score continuously improved in the atorvastatin group ( 34.8 at 7 and 27.6 at 13 mo ) , whereas it slightly deteriorated in the placebo group ( 24.8 at 7 and 26.8 at 13 mo ) . The effect on tinnitus was a tendency without statistic significance ( p = 0.0833 ) . Conclusion : Atorvastatin had no effect on the development of hearing thresholds , but result ed in a trend toward a relief of tinnitus

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Measuring the cost-effectiveness of lipid-lowering drugs in the elderly: the outcomes research and economic analysis components of the PROSPER trial.

Little information exists to quantify the functional status and economic consequences of lipid-lowering therapy in elderly patients . We describe the design of the cost-effectiveness component of the first large , r and omized , placebo-controlled trial of lipid-lowering therapy in subjects aged 70 years or older . The PROspect i ve Study of Pravastatin in the Elderly at Risk has r and omized 5804 men and women 70 - 82 years old , with existing vascular disease or related risk factors , to receive 40 mg/d of pravastatin or placebo . The cost-effectiveness study will be based on within-trial observations of differences between the two study arms in rates of myocardial infa rct ion , stroke and related vascular disease outcomes ( including vascular dementia ) . In addition to comparing within-trial clinical outcomes , we will model the projected changes in life expectancy and cardiovascular outcome rates that would be seen with lifelong use of the drug , based on the risk reduction rates seen in the trial as well as baseline observational data from the three countries where the trial is being conducted ( Scotl and , Irel and and the Netherl and s ) . A state transition ( Markov ) model will be constructed to estimate the likely states of health , functional status and health care re source utilization ( including lipid-lowering drug costs ) in a cohort of elderly patients with versus without pravastatin therapy over a series of 1-year cycles until death . In addition , a st and ard measure of utility ( the Health Utilities Index ) will be administered to all study subjects to permit calculation of quality -adjusted life-years gained with this regimen . This approach will make it possible to go beyond the calculation of a single endpoint for each subject , and to translate the trial findings into definitions of effectiveness and outcomes that will be relevant to the ongoing debate concerning how best to relate the benefits of such medications to their costs

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

The JUPITER Trial: responding to the critics.

p w A s l fi r t t u w h In January 2003 , the Justification for the Use of statins in revention : an Intervention Trial Evaluating Rosuvastatin JUPITER ) investigators began to enroll 17,802 men and omen with no evidence of cardiovascular disease and ormal to low levels of low-density lipoprotein ( LDL ) choesterol into a controversial trial testing whether subjects ith enhanced inflammatory responses might benefit from ggressive statin therapy . At study entry , the mean LDL holesterol level for enrolled participants was just above 00 mg/dl , nearly half had Framingham scores of 10 % , nd none were considered c and i date s for statin therapy under ny current set of prevention guidelines . However , all trial articipants had levels of the inflammatory biomarker highensitivity C-reactive protein ( hsCRP ) 2 mg/L , putting them t substantial risk for future cardiovascular disease . As the JUPITER investigators have since reported in a eries of rigorously peer- review ed reports published in the ew Engl and Journal of Medicine , The Lancet , the nnals of Internal Medicine , Circulation , the Journal of he American College of Cardiology , and The American ournal of Cardiology , r and om allocation to rosuvastatin 0 mg compared to placebo within the trial population esulted in a 54 % reduction in myocardial infa rct ion ( p .0002 ) , a 51 % reduction in ischemic stroke ( p 0.004 ) , a 6 % reduction in need for bypass surgery or angioplasty p 0.0001 ) , a 43 % reduction in venous thromboembolism p 0.002 ) , and a 20 % reduction in all-cause mortality p 0.02 ) . For the JUPITER primary end point of

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Efficacy of rosuvastatin among men and women with moderate chronic kidney disease and elevated high-sensitivity C-reactive protein: a secondary analysis from the JUPITER (Justification for the Use of Statins in Prevention-an Intervention Trial Evaluating Rosuvastatin) trial.

OBJECTIVES We evaluated the efficacy of statin therapy in primary prevention among individuals with moderate chronic kidney disease ( CKD ) . BACKGROUND Whether patents with moderate CKD ( estimated glomerular filtration rate [ eGFR ] < 60 ml/min/1.73 m(2 ) ) benefit from statin therapy is uncertain , particularly among those without hyperlipidemia or known cardiovascular disease . METHODS Within the JUPITER ( Justification for the Use of statins in Prevention-an Intervention Trial Evaluating Rosuvastatin ) primary prevention trial of rosuvastatin 20 mg compared with placebo among men and women free of cardiovascular disease who had low-density lipoprotein cholesterol ( LDL-C ) < 130 mg/dl and high-sensitivity C-reactive protein ( hsCRP ) > or=2 mg/l , we performed a secondary analysis comparing cardiovascular and mortality outcomes among those with moderate CKD at study entry ( n = 3,267 ) with those with baseline eGFR > or=60 ml/min/1.73 m(2 ) ( n = 14,528 ) . Median follow-up was 1.9 years ( maximum 5 years ) . RESULTS Compared with those with eGFR > or=60 ml/min/1.73 m(2 ) , JUPITER participants with moderate CKD had higher vascular event rates ( hazard ratio [ HR ] : 1.54 , 95 % confidence interval [ CI ] : 1.23 to 1.92 , p = 0.0002 ) . Among those with moderate CKD , rosuvastatin was associated with a 45 % reduction in risk of myocardial infa rct ion , stroke , hospital stay for unstable angina , arterial revascularization , or confirmed cardiovascular death ( HR : 0.55 , 95 % CI : 0.38 to 0.82 , p = 0.002 ) and a 44 % reduction in all-cause mortality ( HR : 0.56 , 95 % CI : 0.37 to 0.85 , p = 0.005 ) . Median LDL-C and hsCRP reductions as well as side effect profiles associated with rosuvastatin were similar among those with and without CKD . Median eGFR at 12 months was marginally improved among those allocated to rosuvastatin as compared with placebo . CONCLUSIONS Rosuvastatin reduces first cardiovascular events and all-cause mortality among men and women with LDL-C < 130 mg/dl , elevated hsCRP , and concomitant evidence of moderate CKD . ( JUPITER-Crestor 20 mg Versus Placebo in Prevention of Cardiovascular [ CV ] Events ; NCT00239681 )

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Predictors of new-onset diabetes in patients treated with atorvastatin: results from 3 large randomized clinical trials.

OBJECTIVES We sought to examine the incidence and clinical predictors of new-onset type 2 diabetes mellitus ( T2DM ) within 3 large r and omized trials with atorvastatin . BACKGROUND Statin therapy might modestly increase the risk of new-onset T2DM . METHODS We used a st and ard definition of diabetes and excluded patients with prevalent diabetes at baseline . We identified baseline predictors of new-onset T2DM and compared the event rates in patients with and without new-onset T2DM . RESULTS In the TNT ( Treating to New Targets ) trial , 351 of 3,798 patients r and omized to 80 mg of atorvastatin and 308 of 3,797 r and omized to 10 mg developed new-onset T2DM ( 9.24 % vs. 8.11 % , adjusted hazard ratio [ HR ] : 1.10 , 95 % confidence interval [ CI ] : 0.94 to 1.29 , p = 0.226 ) . In the IDEAL ( Incremental Decrease in End Points Through Aggressive Lipid Lowering ) trial , 239 of 3,737 patients r and omized to atorvastatin 80 mg/day and 208 of 3,724 patients r and omized to simvastatin 20 mg/day developed new-onset T2DM ( 6.40 % vs. 5.59 % , adjusted HR : 1.19 , 95 % CI : 0.98 to 1.43 , p = 0.072 ) . In the SPARCL ( Stroke Prevention by Aggressive Reduction in Cholesterol Levels ) trial , new-onset T2DM developed in 166 of 1,905 patients r and omized to atorvastatin 80 mg/day and in 115 of 1,898 patients in the placebo group ( 8.71 % vs. 6.06 % , adjusted HR : 1.37 , 95 % CI : 1.08 to 1.75 , p = 0.011 ) . In each of the 3 trials , baseline fasting blood glucose , body mass index , hypertension , and fasting triglycerides were independent predictors of new-onset T2DM . Across the 3 trials , major cardiovascular events occurred in 11.3 % of patients with and 10.8 % of patients without new-onset T2DM ( adjusted HR : 1.02 , 95 % CI : 0.77 to 1.35 , p = 0.69 ) . CONCLUSIONS High-dose atorvastatin treatment compared with placebo in the SPARCL trial is associated with a slightly increased risk of new-onset T2DM . Baseline fasting glucose level and features of the metabolic syndrome are predictive of new-onset T2DM across the 3 trials

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Rosuvastatin for Primary Prevention in Older Persons With Elevated C-Reactive Protein and Low to Average Low-Density Lipoprotein Cholesterol Levels: Exploratory Analysis of a Randomized Trial

BACKGROUND R and omized data on statins for primary prevention in older persons are limited , and the relative hazard of cardiovascular disease associated with an elevated cholesterol level weakens with advancing age . OBJECTIVE To assess the efficacy and safety of rosuvastatin in persons 70 years or older . DESIGN Secondary analysis of JUPITER ( Justification for the Use of statins in Prevention : an Intervention Trial Evaluating Rosuvastatin ) , a r and omized , double-blind , placebo-controlled trial . SETTING 1315 sites in 26 countries r and omly assigned participants in JUPITER . PARTICIPANTS Among the 17 802 participants r and omly assigned with low-density lipoprotein ( LDL ) cholesterol levels less than 3.37 mmol/L ( < 130 mg/dL ) and high-sensitivity C-reactive protein levels of 2.0 mg/L or more without cardiovascular disease , 5695 were 70 years or older . INTERVENTION Participants were r and omly assigned in a 1:1 ratio to receive 20 mg of rosuvastatin daily or placebo . MEASUREMENTS The primary end point was the occurrence of a first cardiovascular event ( myocardial infa rct ion , stroke , arterial revascularization , hospitalization for unstable angina , or death from cardiovascular causes ) . RESULTS The 32 % of trial participants 70 years or older accrued 49 % ( n = 194 ) of the 393 confirmed primary end points . The rates of the primary end point in this age group were 1.22 and 1.99 per 100 person-years of follow-up in the rosuvastatin and placebo groups , respectively ( hazard ratio , 0.61 [ 95 % CI , 0.46 to 0.82 ] ; P < 0.001 ) . Corresponding rates of all-cause mortality in this age group were 1.63 and 2.04 ( hazard ratio , 0.80 [ CI , 0.62 to 1.04 ] ; P = 0.090 ) . Although no significant heterogeneity was found in treatment effects by age , absolute reductions in event rates associated with rosuvastatin were greater in older persons . The relative rate of any serious adverse event among older persons in the rosuvastatin versus placebo group was 1.05 ( CI , 0.93 to 1.17 ) . LIMITATION Effect estimates from this exploratory analysis with age cut-point chosen after trial completion should be viewed in the context of the overall trial results . CONCLUSION In apparently healthy older persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels , rosuvastatin reduces the incidence of major cardiovascular events . PRIMARY FUNDING SOURCE AstraZeneca

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Statins for Asymptomatic Middle Cerebral Artery Stenosis: The Regression of Cerebral Artery Stenosis Study

Background : The progression of cerebral atherosclerosis increases the risk of stroke and vascular events . Given the known benefits of statins in retarding coronary and carotid atherosclerosis progression , we studied the effects of statins on asymptomatic middle cerebral artery ( MCA ) stenosis progression . Methods : We conducted a r and omized , double-blind , placebo-controlled study to evaluate the effects of simvastatin on the progression of MCA stenosis among stroke-free individuals who had mild to moderately elevated LDL cholesterol ( 3.0–5.0 mmol/l ) . Two hundred and twenty-seven subjects were r and omized to either placebo ( n = 114 ) or simvastatin 20 mg daily ( n = 113 ) . The severity of MCA stenosis at baseline and at the end of the study was grade d by MRA into normal , minimal ( < 10 % ) , mild ( 10–49 % ) , moderate ( 50–90 % ) and severe ( > 90 % ) . The primary outcome was the change in grading of MCA stenosis over 2 years . Results : At the end of the study , the LDL cholesterol level decreased by 1.43 and 0.12 mmol/l for the active and placebo groups , respectively ( p < 0.001 ) . There was no significant difference in the proportion of patients having stable , progressive and regressive MCA stenosis between the placebo ( 72 , 22 and 6 % ) and active groups ( 78.6 , 15.5 and 5.8 % ) . The all-cause mortality was significantly lower in the active group ( n = 0 ) relative to the placebo group ( n = 7 , p = 0.014 ) . Any clinical events were also lower in the active group ( n = 5 ) than in the placebo group ( n = 13 , p = 0.052 ) . Conclusions : Simvastatin 20 mg daily had no apparent effect upon the evolution of asymptomatic MCA stenosis over 2 years

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Effect of Lipid Lowering With Rosuvastatin on Progression of Aortic Stenosis: Results of the Aortic Stenosis Progression Observation: Measuring Effects of Rosuvastatin (ASTRONOMER) Trial

Background — Aortic stenosis ( AS ) is an active process with similarities to atherosclerosis . The objective of this study was to assess the effect of cholesterol lowering with rosuvastatin on the progression of AS . Methods and Results — This was a r and omized , double-blind , placebo-controlled trial in asymptomatic patients with mild to moderate AS and no clinical indications for cholesterol lowering . The patients were r and omized to receive either placebo or rosuvastatin 40 mg daily . A total of 269 patients were r and omized : 134 patients to rosuvastatin 40 mg daily and 135 patients to placebo . Annual echocardiograms were performed to assess AS progression , which was the primary outcome ; the median follow-up was 3.5 years . The peak AS gradient increased in patients receiving rosuvastatin from a baseline of 40.8±11.1 to 57.8±22.7 mm Hg at the end of follow-up and in patients with placebo from 41.6±10.9 mm Hg at baseline to 54.8±19.8 mm Hg at the end of follow-up . The annualized increase in the peak AS gradient was 6.3±6.9 mm Hg in the rosuvastatin group and 6.1±8.2 mm Hg in the placebo group ( P=0.83 ) . Treatment with rosuvastatin was not associated with a reduction in AS progression in any of the predefined subgroups . Conclusion — Cholesterol lowering with rosuvastatin 40 mg did not reduce the progression of AS in patients with mild to moderate AS ; thus , statins should not be used for the sole purpose of reducing the progression of AS . Clinical Trial Registration Information— URL : http://www.controlled-trials.com/. Clinical trial registration number : IS RCT N 32424163

Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects . There was no evidence of any serious harm caused by statin prescription . Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life . Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event . AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins

BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy . Statins are the first-choice agents . Previous review s of the effects of statins have highlighted their benefits in people with CVD . The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required . OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial.

BACKGROUND Effects of diet on blood lipids are best known in white men , and effects of type of carbohydrate on triacylglycerol concentrations are not well defined . OBJECTIVE Our goal was to determine the effects of diet on plasma lipids , focusing on subgroups by sex , race , and baseline lipid concentrations . DESIGN This was a r and omized controlled outpatient feeding trial conducted in 4 field centers . The subjects were 436 participants of the Dietary Approaches to Stop Hypertension ( DASH ) Trial [ mean age : 44.6 y ; 60 % African American ; baseline total cholesterol : < or = 6.7 mmol/L ( < or = 260 mg/dL ) ] . The intervention consisted of 8 wk of a control diet , a diet increased in fruit and vegetables , or a diet increased in fruit , vegetables , and low-fat dairy products and reduced in saturated fat , total fat , and cholesterol ( DASH diet ) , during which time subjects remained weight stable . The main outcome measures were fasting total cholesterol , LDL cholesterol , HDL cholesterol , and triacylglycerol . RESULTS Relative to the control diet , the DASH diet result ed in lower total ( -0.35 mmol/L , or -13.7 mg/dL ) , LDL- ( -0.28 mmol/L , or -10.7 mg/dL ) , and HDL- ( -0.09 mmol/L , or -3.7 mg/dL ) cholesterol concentrations ( all P < 0.0001 ) , without significant effects on triacylglycerol . The net reductions in total and LDL cholesterol in men were greater than those in women by 0.27 mmol/L , or 10.3 mg/dL ( P = 0.052 ) , and by 0.29 mmol/L , or 11.2 mg/dL ( P < 0.02 ) , respectively . Changes in lipids did not differ significantly by race or baseline lipid concentrations , except for HDL , which decreased more in participants with higher baseline HDL-cholesterol concentrations than in those with lower baseline HDL-cholesterol concentrations . The fruit and vegetable diet produced few significant lipid changes . CONCLUSIONS The DASH diet is likely to reduce coronary heart disease risk . The possible opposing effect on coronary heart disease risk of HDL reduction needs further study

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Low-fat, high-fiber diet favorably affects several independent risk markers of ischemic heart disease: observations on blood lipids, coagulation, and fibrinolysis from a trial of middle-aged Danes.

We served a low-fat ( 28 % of energy ) , high-fiber ( 3.3 g/MJ ) diet according to Nordic nutrition recommendations ( Rec diet ) , and a high-fat diet ( 39 % of energy ) corresponding to the average Danish diet ( Dane diet ) for periods of 2 wk in a r and omized crossover study of 21 healthy middle-aged individuals . The Rec diet result ed in lower serum concentrations of low-density-lipoprotein ( LDL ) cholesterol ( medians : 2.77 vs 3.04 mmol/L , P < 0.001 ) and high-density-lipoprotein ( HDL ) cholesterol ( 1.08 vs 1.24 mmol/L , P < 0.001 ) , and higher fasting triglycerides ( 1.11 vs 0.86 mmol/L , P = 0.04 ) than did the Dane diet . Furthermore , the Rec diet lowered plasma factor VII coagulant activity ( FVIIc ) ( 88 % vs 96 % , P = 0.002 ) and raised plasma fibrinolytic activity . Our observations indicate that a low-fat , high-fiber diet may not only reduce the atherogenic but also the thrombogenic tendency of an individual compared with a diet corresponding to the average Danish diet

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Effectiveness of a weight loss intervention in postpartum women: results from a randomized controlled trial in primary health care.

BACKGROUND Reproduction has been identified as an important factor for long-term weight gain among women . A previous efficacy trial has successfully produced postpartum weight loss ; however , the effectiveness of this intervention needs to be established . OBJECTIVE This study was design ed to evaluate the short- and long-term effectiveness of a diet behavior modification treatment to produce weight loss in postpartum women within the primary health care setting in Sweden . DESIGN During 2011 - 2014 , 110 women with a self-reported body mass index ( BMI ; in kg/m(2 ) ) of ≥27 at 6 - 15 wk postpartum were r and omly assigned to the diet behavior modification group ( D group ) or the control group ( C group ) . Women r and omly assigned to the D group ( n = 54 ) received a structured 12-wk diet behavior modification treatment by a dietitian and were instructed to gradually implement a diet plan based on the Nordic Nutrition Recommendations and to self-weigh ≥3 times/wk . Women r and omly assigned to the C group ( n = 56 ) were given a brochure on healthy eating . The primary outcome was change in body weight after 12 wk and 1 y. The retention rate was 91 % and 85 % at 12 wk and 1 y , respectively . RESULTS At baseline , women had a median ( 1st , 3rd quartile ) BMI of 31.0 ( 28.8 , 33.6 ) , and 84 % were breastfeeding . After 12 wk , median weight change in the D group was -6.1 kg ( -8.4 , -3.2 kg ) compared with -1.6 kg ( -3.5 , -0.4 kg ) in the C group ( P < 0.001 ) . The difference was maintained at the 1-y follow-up for the D group , -10.0 kg ( -11.7 , -5.9 kg ) compared with -4.3 kg ( -10.2 , -1.0 kg ) in the C group ( P = 0.004 ) . In addition , the D group reduced BMI , waist circumference , hip circumference , and body fat percentage more than did the C group at both 12 wk and 1 y ( all P < 0.05 ) . CONCLUSION A low-intensity diet treatment delivered by a dietitian within the primary health care setting can produce clinical ly relevant and sustainable weight loss in postpartum women with overweight and obesity . This trial was registered at clinical trials.gov as NCT01949558

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Health effect of the New Nordic Diet in adults with increased waist circumference: a 6-mo randomized controlled trial.

BACKGROUND The regional Mediterranean Diet has been associated with lower risk of disease . OBJECTIVE We tested the health effects of the New Nordic Diet ( NND ) , which is a gastronomically driven regional , organic , and environmentally friendly diet , in a carefully controlled but free-living setting . DESIGN A total of 181 central ly obese men and women , with a mean ( range ) age of 42 y ( 20 - 66 y ) , body mass index ( in kg/m(2 ) ) of 30.2 ( 22.6 - 47.3 ) , and waist circumference of 100 cm ( 80 - 138 cm ) were r and omly assigned to receive either the NND ( high in fruit , vegetables , whole grains , and fish ) or an average Danish diet ( ADD ) for 26 wk . Participants received cookbooks and all foods ad libitum and free of charge by using a shop model . The primary endpoint was the weight change analyzed by both completer and intention-to-treat analyses . RESULTS A total of 147 subjects [ 81 % ( NND 81 % ; ADD 82 % ) ] completed the intervention . A high dietary compliance was achieved , with significant differences in dietary intakes between groups . The mean ( ±SEM ) weight change was -4.7 ± 0.5 kg for the NND compared with -1.5 ± 0.5 kg for the ADD ( adjusted difference : -3.2 kg ; 95 % CI : -4.6 , -1.8 kg ; P < 0.001 ) for the completer analysis , and the difference was -3.0 kg ( 95 % CI : -4.0 , -2.1 kg ) for the intention-to-treat analysis . The NND produced greater reductions in systolic blood pressure ( adjusted difference : -5.1 mm Hg ; 95 % CI : -8.2 , -2.1 mm Hg ) and diastolic blood pressure ( adjusted difference : -3.2 mm Hg ; 95 % CI : -5.7 , -0.8 mm Hg ) than did the ADD . CONCLUSION An ad libitum NND produces weight loss and blood pressure reduction in central ly obese individuals . This trial was registered at www . clinical trials.gov as NCT01195610

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Effects of school meals with weekly fish servings on vitamin D status in Danish children: secondary outcomes from the OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet) School Meal Study

Children 's vitamin D intake and status can be optimised to meet recommendations . We investigated if nutritionally balanced school meals with weekly fish servings affected serum 25-hydroxyvitamin D ( 25(OH)D ) and markers related to bone in 8- to 11-year-old Danish children . We conducted an explorative secondary outcome analysis on data from 784 children from the OPUS School Meal Study , a cluster-r and omised cross-over trial where children received school meals for 3 months and habitual lunch for 3 months . At baseline , and at the end of each dietary period , 25(OH)D , parathyroid hormone ( PTH ) , osteocalcin ( OC ) , insulin-like growth factor-1 ( IGF-1 ) , bone mineral content ( BMC ) , bone area ( BA ) , bone mineral density ( BMD ) , dietary intake and physical activity were assessed . School meals increased vitamin D intake by 0·9 ( 95 % CI 0·7 , 1·1 ) μg/d . No consistent effects were found on 25(OH)D , BMC , BA , BMD , IGF-1 or OC . However , season-modified effects were observed with 25(OH)D , i.e. children completing the school meal period in January/February had higher 25(OH)D status ( 5·5 ( 95 % CI 1·8 , 9·2 ) nmol/l ; P = 0·004 ) than children completing the control period in these months . A similar tendency was indicated in November/December ( 4·1 ( 95 % CI –0·12 , 8·3 ) nmol/l ; P = 0·057 ) . However , the effect was opposite in March/April ( –4·0 ( 95 % CI –7·0 , –0·9 ) nmol/l ; P = 0·010 ) , and no difference was found in May/June ( P = 0·214 ) . Unexpectedly , the school meals slightly increased PTH ( 0·18 ( 95 % CI 0·07 , 0·29 ) pmol/l ) compared with habitual lunch . Small increases in dietary vitamin D might hold potential to mitigate the winter nadir in Danish children 's 25(OH)D status while higher increases appear necessary to affect status throughout the year . More trials on effects of vitamin D intake from natural foods are needed

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

The effects of Nordic school meals on concentration and school performance in 8- to 11-year-old children in the OPUS School Meal Study: a cluster-randomised, controlled, cross-over trial.

It is widely assumed that nutrition can improve school performance in children ; however , evidence remains limited and inconclusive . In the present study , we investigated whether serving healthy school meals influenced concentration and school performance of 8- to 11-year-old Danish children . The OPUS ( Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ) School Meal Study was a cluster-r and omised , controlled , cross-over trial comparing a healthy school meal programme with the usual packed lunch from home ( control ) each for 3 months ( NCT 01457794 ) . The d2 test of attention , the Learning Rating Scale ( LRS ) and st and ard tests on reading and mathematics proficiency were administered at baseline and at the end of each study period . Intervention effects were evaluated using hierarchical mixed models . The school meal intervention did not influence concentration performance ( CP ; primary outcome , n 693 ) or processing speed ; however , the decrease in error percentage was 0·18 points smaller ( P<0·001 ) in the intervention period than in the control period ( medians : baseline 2·03 % ; intervention 1·46 % ; control 1·37 % ) . In contrast , the intervention increased reading speed ( 0·7 sentence , P=0·009 ) and the number of correct sentences ( 1·8 sentences , P<0·001 ) , which corresponded to 11 and 25 % , respectively , of the effect of one school year . The percentage of correct sentences also improved ( P<0·001 ) , indicating that the number correct improved relatively more than reading speed . There was no effect on overall math performance or outcomes from the LRS . In conclusion , school meals did not affect CP , but improved reading performance , which is a complex cognitive activity that involves inference , and increased errors related to impulsivity and inattention . These findings are worth examining in future trials

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Plate waste and intake of school lunch based on the new Nordic diet and on packed lunches: a randomised controlled trial in 8- to 11-year-old Danish children

The aim of the present study was to compare total food intake , total and relative edible plate waste and self-reported food likings between school lunch based on the new Nordic diet ( NND ) and packed lunch from home . In two 3-month periods in a cluster-r and omised controlled unblinded cross-over study 3rd- and 4th- grade children ( n 187 ) from two municipal schools received lunch meals based on NND principles and their usual packed lunch ( control ) . Food intake and plate waste ( n 1558 ) were calculated after weighing lunch plates before and after the meal for five consecutive days and self-reported likings ( n 905 ) assessed by a web-based question naire . Average food intake was 6 % higher for the NND period compared with the packed lunch period . The quantity of NND intake varied with the menu ( P < 0·0001 ) and was positively associated with self-reported likings . The edible plate waste was 88 ( sd 80 ) g for the NND period and 43 ( sd 60 ) g for the packed lunch period whereas the relative edible plate waste was no different between periods for meals having waste ( n 1050 ) . Edible plate waste differed between menus ( P < 0·0001 ) , with more waste on soup days ( 36 % ) and vegetarian days ( 23 % ) compared with the packed lunch period . Self-reported likings were negatively associated with percentage plate waste ( P < 0·0001 ) . The study suggests that portion sizes need to be considered in new school meal programmes . New strategies with focus on reduction of plate waste , children 's likings and nutritious school meals are crucial from both a nutritional , economic and environmental point of view

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task

Objective : It has been suggested that overweight is negatively associated with cognitive functions . The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women . Methods : 20 overweight postmenopausal women were r and omized to either a modified paleolithic diet or a st and ard diet adhering to the Nordic Nutrition Recommendations for 6 months . We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions . Results : Episodic memory performance improved significantly ( p = 0.010 ) after the dietary interventions . Concomitantly , brain activity increased in the anterior part of the right hippocampus during memory encoding , without differences between diets . This was associated with decreased levels of plasma free fatty acids ( FFA ) . Brain activity increased in pre-frontal cortex and superior/middle temporal gyri . The magnitude of increase correlated with waist circumference reduction . During episodic retrieval , brain activity decreased in inferior and middle frontal gyri , and increased in middle/superior temporal gyri . Conclusions : Diet-induced weight loss , associated with decreased levels of plasma FFA , improves episodic memory linked to increased hippocampal activity

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Dietary effects of introducing school meals based on the New Nordic Diet - a randomised controlled trial in Danish children. The OPUS School Meal Study.

The OPUS ( Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ( NND ) ) School Meal Study investigated the effects on the intake of foods and nutrients of introducing school meals based on the principles of the NND covering lunch and all snacks during the school day in a cluster-r and omised cross-over design . For two 3-month periods , 834 Danish children aged 8 - 11 years from forty-six school classes at nine schools received NND school meals or their usual packed lunches brought from home ( control ) in r and om order . The whole diet of the children was recorded over seven consecutive days using a vali date d Web-based Dietary Assessment Software for Children . The NND result ed in higher intakes of potatoes ( 130 % , 95 % CI 2·07 , 2·58 ) , fish ( 48 % , 95 % CI 1·33 , 1·65 ) , cheese ( 25 % , 95 % CI 1·15 , 1·36 ) , vegetables ( 16 % , 95 % CI 1·10 , 1·21 ) , eggs ( 10 % , 95 % CI 1·01 , 1·19 ) and beverages ( 6 % , 95 % CI 1·02 , 1·09 ) , and lower intakes of bread ( 13 % , 95 % CI 0·84 , 0·89 ) and fats ( 6 % , 95 % CI 0·90 , 0·98 ) were found among the children during the NND period than in the control period ( all , P < 0·05 ) . No difference was found in mean energy intake ( P= 0·4 ) , but on average children reported 0·9 % less energy intake from fat and 0·9 % higher energy intake from protein during the NND period than in the control period . For micronutrient intakes , the largest differences were found for vitamin D ( 42 % , 95 % CI 1·32 , 1·53 ) and iodine ( 11 % , 95 % CI 1·08 , 1·15 ) due to the higher fish intake . In conclusion , the present study showed that the overall dietary intake at the food and nutrient levels was improved among children aged 8 - 11 years when their habitual packed lunches were replaced by school meals following the principles of the NND

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes—The Danish Diet, Cancer and Health Cohort Study

Background : Type-2 diabetes ( T2D ) prevalence is rapidly increasing worldwide . Lifestyle factors , in particular obesity , diet , and physical activity play a significant role in the etiology of the disease . Of dietary patterns , particularly the Mediterranean diet has been studied , and generally a protective association has been identified . However , other regional diets are less explored . Objective : The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D . The index consists of six food items : fish , cabbage , rye bread , oatmeal , apples and pears , and root vegetables . Methods : Data was obtained from a prospect i ve cohort study of 57,053 Danish men and women aged 50–64 years , at baseline , of whom 7366 developed T2D ( median follow-up : 15.3 years ) . The Cox proportional hazards model was used to assess the association between the healthy Nordic food index and risk of T2D , adjusted for potential confounders . Results : Greater adherence to the healthy Nordic food index was significantly associated with lower risk of T2D after adjusting for potential confounders . An index score of 5−6 points ( high adherence ) was associated with a statistically significantly 25 % lower T2D risk in women ( HR : 0.75 , 95%CI : 0.61–0.92 ) and 38 % in men ( HR : 0.62 ; 95%CI : 0.53–0.71 ) compared to those with an index score of 0 points ( poor adherence ) . Conclusion : Adherence to a healthy Nordic food index was found to be inversely associated with risk of T2D , suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

No association between adherence to the healthy Nordic food index and cardiovascular disease amongst Swedish women: a cohort study.

BACKGROUND In several intervention trials , a healthy Nordic diet showed beneficial effects on markers of cardiovascular disease . We investigated the association between a healthy Nordic diet and clinical diagnosis of cardiovascular disease . OBJECTIVE Our aim was first to examine the association between a healthy Nordic food index ( wholegrain bread , oatmeal , apples/pears , root vegetables , cabbages and fish ) and the incidence of overall cardiovascular disease ( ischaemic heart disease , stroke , arrhythmia , thrombosis and hypertensive disease ) , and secondly to test for possible effect modification by smoking , body mass index ( BMI ) , alcohol consumption and age . METHODS We conducted an analysis of data from the prospect i ve Swedish Women 's Lifestyle and Health cohort , including 43 310 women who completed a food frequency question naire in 1991 - 1992 , and followed up until 31 December 2012 through Swedish registries . Hazard ratios ( HRs ) and 95 % confidence intervals ( CIs ) were calculated using Cox proportional hazards models . RESULTS During follow-up , 8383 women developed cardiovascular disease . We found no association between the healthy Nordic food index and overall cardiovascular disease risk or any of the subgroups investigated . There was a statistically significant interaction with smoking status ( P = 0.02 ) , with a beneficial effect only amongst former smokers ( HR 0.96 , 95 % CI 0.94 - 0.99 per 1-point increment ) . CONCLUSION The present results do not support an association between a healthy Nordic food index and risk of cardiovascular disease in Swedish women . There was also no effect modification by alcohol intake , BMI or age . Our finding of an interaction with smoking status requires reproduction

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Plasma alkylresorcinols C17:0/C21:0 ratio, a biomarker of relative whole-grain rye intake, is associated to insulin sensitivity: a randomized study

Background / Objectives : Few studies have used biomarkers of whole-grain intake to study its relation to glucose metabolism . We aim ed to investigate the association between plasma alkylresorcinols ( AR ) , a biomarker of whole-grain rye and wheat intake , and glucose metabolism in individuals with metabolic syndrome (MetS).Subjects/ Methods : Participants were 30–65 years of age , with body mass index 27–40 kg/m2 and had MetS without diabetes . Individuals were recruited through six centers in the Nordic countries and r and omized to a healthy Nordic diet ( ND , n=96 ) , rich in whole-grain rye and wheat , or a control diet ( n=70 ) , for 18–24 weeks . In addition , associations between total plasma AR concentration and C17:0/C21:0 homolog ratio as an indication of the relative whole-grain rye intake , and glucose metabolism measures from oral glucose tolerance tests were investigated in pooled ( ND+control ) regression analyses at 18/24 weeks . Results : ND did not improve glucose metabolism compared with control diet , but the AR C17:0/C21:0 ratio was inversely associated with fasting insulin concentrations ( P=0.002 ) and positively associated with the insulin sensitivity indices Matsuda ISI ( P=0.026 ) and disposition index ( P=0.022 ) in pooled analyses at 18/24 weeks , even after adjustment for confounders . The AR C17:0/C21:0 ratio was not significantly associated with insulin secretion indices . Total plasma AR concentration was not related to fasting plasma glucose or fasting insulin at 18/24 weeks . Conclusions : The AR C17:0/C21:0 ratio , an indicator of relative whole-grain rye intake , is associated with increased insulin sensitivity in a population with

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

An olive oil-rich diet results in higher concentrations of LDL cholesterol and a higher number of LDL subfraction particles than rapeseed oil and sunflower oil diets.

We investigated the effect of olive oil , rapeseed oil , and sunflower oil on blood lipids and lipoproteins including number and lipid composition of lipoprotein subclasses . Eighteen young , healthy men participated in a double-blinded r and omized cross-over study ( 3-week intervention period ) with 50 g of oil per 10 MJ incorporated into a constant diet . Plasma cholesterol , triacylglycerol , apolipoprotein B , and very low density lipoprotein ( VLDL ) , intermediate density lipoprotein ( IDL ) , and low density lipoprotein ( LDL ) cholesterol concentrations were 10;-20 % higher after consumption of the olive oil diet compared with the rapeseed oil and sunflower oil diets [ analysis of variance ( ANOVA ) , P < 0.05 ] . The size of IDL , VLDL , and LDL subfractions did not differ between the diets , whereas a significantly higher number ( apolipoprotein B concentration ) and lipid content of the larger and medium-sized LDL subfractions were observed after the olive oil diet compared with the rapeseed oil and sunflower oil diets ( ANOVA , P < 0.05 ) . Total HDL cholesterol concentration did not differ significantly , but HDL(2a ) cholesterol was higher after olive oil and rapeseed oil compared with sunflower oil ( ANOVA , P < 0.05).In conclusion , rapeseed oil and sunflower oil had more favorable effects on blood lipids and plasma apolipoproteins as well as on the number and lipid content of LDL subfractions compared with olive oil . Some of the differences may be attributed to differences in the squalene and phytosterol contents of the oils

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Influence of a prudent diet on circulating cathepsin S in humans

Background Increased circulating cathepsin S levels have been linked to increased risk of cardiometabolic diseases and cancer . However , whether cathepsin S is a modifiable risk factor is unclear . We aim ed to investigate the effects of a prudent diet on plasma cathepsin S levels in healthy individuals . Findings Explorative analyses of a r and omized study were performed in 88 normal to slightly overweight and hyperlipidemic men and women ( aged 25 to 65 ) that were r and omly assigned to ad libitum prudent diet , i.e. healthy Nordic diet ( ND ) or a control group ( habitual Western diet ) for 6 weeks . Whereas all foods in the ND were provided , the control group was advised to consume their habitual diet throughout the study . The ND was in line with dietary recommendations , e.g. low in saturated fats , sugars and salt , but high in plant-based foods rich in fibre and unsaturated fats . The ND significantly decreased cathepsin S levels ( from 20.1 ( + /-4.0 SD ) to 19.7 μg/L ( + /-4.3 SD ) ) compared with control group ( from 18.2 ( + /-2.9 SD ) to 19.1 μg/L ( + /-3.8 SD ) ) . This difference remained after adjusting for sex and change in insulin sensitivity ( P = 0.03 ) , and near significant after adjusting for baseline cathepsin S levels ( P = 0.06 ) , but not for change in weight or LDL-C. Changes in cathepsin S levels were directly correlated with change in LDL-C. Conclusions Compared with a habitual control diet , a provided ad libitum healthy Nordic diet decreased cathepsin S levels in healthy individuals , possibly mediated by weight loss or lowered LDL-C. These differences between groups in cathepsin S were however not robust and therefore need further investigation

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Diet-induced changes in iron and n-3 fatty acid status and associations with cognitive performance in 8-11-year-old Danish children: secondary analyses of the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet School Meal Study.

Fe and n-3 long-chain PUFA ( n-3 LCPUFA ) have both been associated with cognition , but evidence remains inconclusive in well-nourished school-aged children . In the Optimal Well-Being , Development and Health for Danish Children through a Healthy New Nordic Diet ( OPUS ) School Meal Study , the 3-month intervention increased reading performance , inattention , impulsivity and dietary intake of fish and Fe . This study investigated whether the intervention influenced n-3 LCPUFA and Fe status and , if so , explored how these changes correlated with the changes in cognitive performance . The study was a cluster-r and omised cross-over trial comparing school meals with packed lunch ( control ) . At baseline and after each treatment , we measured serum ferritin , whole-blood n-3 LCPUFA and Hb , and performance in reading , mathematics and d2-test of attention . Data were analysed using mixed models ( n 726 ) and principal component analysis of test performances ( n 644 ) , which showed two main patterns : ' school performance ' and ' reading comprehension ' . The latter indicated that children with good reading comprehension were also more inattentive and impulsive ( i.e. higher d2-test error% ) . The intervention improved ' school performance ' ( P=0·015 ) , ' reading comprehension ' ( P=0·043 ) and EPA+DHA status 0·21 ( 95 % CI 0·15 , 0·27 ) w/w % ( P<0·001 ) , but it did not affect serum ferritin or Hb . At baseline , having small Fe stores was associated with poorer ' school performance ' in girls , but with better ' reading comprehension ' in both boys and girls . Both baseline EPA+DHA status and the intervention-induced increase in EPA+DHA status was positively associated with ' school performance ' , suggesting that n-3 LCPUFA could potentially explain approximately 20 % of the intervention effect . These exploratory associations indicate that increased fish intake might explain some of the increase in reading performance and inattention in the study

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Effects of school meals based on the New Nordic Diet on intake of signature foods: a randomised controlled trial. The OPUS School Meal Study.

A New Nordic Diet ( NND ) was developed in the context of the Danish OPUS Study ( Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ) . Health , gastronomic potential , sustainability and Nordic identity were crucial principles of the NND . The aim of the present study was to investigate the effects of serving NND school meals compared with the usual packed lunches on the dietary intake of NND signature foods . For two 3-month periods , 834 Danish children aged 8 - 11 years received NND school meals or their usual packed lunches brought from home ( control ) in r and om order . The entire diet was recorded over 7 consecutive days using a vali date d Web-based Dietary Assessment Software for Children . The NND result ed in higher intakes during the entire week ( % increase ) of root vegetables ( 116 ( 95 % CI 1·93 , 2·42 ) ) , cabbage ( 26 ( 95 % CI 1·08 , 1·47 ) ) , legumes ( 22 ( 95 % CI 1·06 , 1·40 ) ) , herbs ( 175 ( 95 % CI 2·36 , 3·20 ) ) , fresh berries ( 48 ( 95 % CI 1·13 , 1·94 ) ) , nuts and seeds ( 18 ( 95 % CI 1·02 , 1·38 ) ) , lean fish and fish products ( 47 ( 95 % CI 1·31 , 1·66 ) ) , fat fish and fish products ( 18 ( 95 % CI 1·02 , 1·37 ) ) and potatoes ( 129 ( 95 % CI 2·05 , 2·56 ) ) . Furthermore , there was a decrease in the number of children with zero intakes when their habitual packed lunches were replaced by NND school meals . In conclusion , this study showed that the children increased their intake of NND signature foods , and , furthermore , there was a decrease in the number of children with zero intakes of NND signature foods when their habitual packed lunches were replaced by school meals following the NND principles

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Adherence to the healthy Nordic food index and total and cause-specific mortality among Swedish women

Several healthy dietary patterns have been linked to longevity . Recently , a Nordic dietary pattern was associated with a lower overall mortality . No study has , however , investigated this dietary pattern in relation to cause-specific mortality . The aim of the present study was to examine the association between adherence to a healthy Nordic food index ( consisting of wholegrain bread , oatmeal , apples/pears , root vegetables , cabbages and fish/shellfish ) and overall mortality , and death by cardiovascular disease , cancer , injuries/suicide and other causes . We conducted a prospect i ve analysis in the Swedish Women ’s Lifestyle and Health cohort , including 44,961 women , aged 29–49 years , who completed a food frequency question naire between 1991–1992 , and have been followed up for mortality ever since , through Swedish registries . The median follow-up time is 21.3 years , and mortality rate ratios ( MRR ) were calculated using Cox Proportional Hazards Models . Compared to women with the lowest index score ( 0–1 points ) , those with the highest score ( 4–6 points ) had an 18 % lower overall mortality ( MRR 0.82 ; 0.71–0.93 , p < 0.0004 ) . A 1-point increment in the healthy Nordic food index was associated with a significantly lower risk of all-cause mortality : 6 % ( 3–9 % ) , cancer mortality : 5 % ( 1–9 % ) and mortality from other causes : 16 % ( 8–22 % ) . When examining the diet components individually , only wholegrain bread and apples/pears were significantly inversely associated with all-cause mortality . We observed no effect-modification by smoking status , BMI or age at baseline . The present study encourages adherence to a healthy Nordic food index , and warrants further investigation of the strong association with non-cancer , non-cardiovascular and non-injury/suicide deaths

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins – results from the NORDIET study

Background The fatty acid ( FA ) composition of serum lipids is related to the quality of dietary fat intake . Objective To investigate the effects of a healthy Nordic diet ( ND ) on the FA composition of serum cholesterol esters ( CE-FA ) and assess the associations between changes in the serum CE-FA composition and blood lipoproteins during a controlled dietary intervention . Design The NORDIET trial was a 6-week r and omised , controlled , parallel-group dietary intervention study that included 86 adults ( 53±8 years ) with elevated low-density lipoprotein cholesterol ( LDL-C ) . Serum CE-FA composition was measured using gas chromatography . Diet history interviews were conducted , and daily intake was assessed using checklists . Results Food and nutrient intake data indicated that there was a reduction in the intake of fat from dairy and meat products and an increase in the consumption of fatty fish with the ND . The levels of saturated fatty acids in cholesterol esters ( CE-SFA ) 14:0 , 15:0 , and 18:0 , but not 16:0 , showed a significant decrease after intake of ND compared to the control diet ( p<0.01 ) . Also , a significant increase in serum 22:6n – 3 was observed compared with the control diet ( p<0.01 ) . The changes in CE-SFA 14:0 , 15:0 , and 18:0 correlated positively with changes in LDL-C , HDL-C , LDL-C/HDL-C , ApoA1 , and ApoB ( p<0.01 ) , respectively , whereas the changes in polyunsaturated fatty acids in cholesterol esters ( CE-PUFA ) 22:6n – 3 were negatively correlated with changes in the corresponding serum lipids . Conclusions The decreased intake of saturated fat and increased intake of n-3 PUFA in a healthy ND is partly reflected by changes in the serum CE-FA composition , which are associated with an improved serum lipoprotein pattern

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Accuracy of self-reported intake of signature foods in a school meal intervention study: comparison between control and intervention period.

Bias in self-reported dietary intake is important when evaluating the effect of dietary interventions , particularly for intervention foods . However , few have investigated this in children , and none have investigated the reporting accuracy of fish intake in children using biomarkers . In a Danish school meal study , 8- to 11-year-old children ( n 834 ) were served the New Nordic Diet ( NND ) for lunch . The present study examined the accuracy of self-reported intake of signature foods ( berries , cabbage , root vegetables , legumes , herbs , potatoes , wild plants , mushrooms , nuts and fish ) characterising the NND . Children , assisted by parents , self-reported their diet in a Web-based Dietary Assessment Software for Children during the intervention and control ( packed lunch ) periods . The reported fish intake by children was compared with their ranking according to fasting whole-blood EPA and DHA concentration and weight percentage using the Spearman correlations and cross-classification . Direct observation of school lunch intake ( n 193 ) was used to score the accuracy of food-reporting as matches , intrusions , omissions and faults . The reporting of all lunch foods had higher percentage of matches compared with the reporting of signature foods in both periods , and the accuracy was higher during the control period compared with the intervention period . Both Spearman 's rank correlations and linear mixed models demonstrated positive associations between EPA+DHA and reported fish intake . The direct observations showed that both reported and real intake of signature foods did increase during the intervention period . In conclusion , the self-reported data represented a true increase in the intake of signature foods and can be used to examine dietary intervention effects

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

No Association between Adherence to a Healthy Nordic Food Index and Colorectal Cancer: Results from a Swedish Cohort Study

Background : Recently , the Nordic diet has gained interest , and a healthy Nordic food index has been developed , which has been found inversely related to colorectal cancer among Danish women . This single finding , however , requires replication in other cohorts . Methods : We conducted a prospect i ve study in the Women 's Lifestyle and Health cohort , including 45,222 women , recruited in 1991–92 , and followed up ever since through Swedish registries . Participants were classified according to the Nordic food index ( consisting of whole grain bread , oatmeal , apples/pears , cabbages , root vegetables , and fish/shellfish ) , and the association between adherence and colorectal cancer was assessed using the Cox proportional hazards models . Results : In the fully adjusted models , we found no association , neither with the continuous index score [ incidence rate ratio ( IRR ) , 1.04 ; 95 % confidence interval ( CI ) , 0.95–1.12 , per 1-point increment ] nor in the categorical analyses ( IRR , 1.09 ; 95 % CI , 0.78–1.52 for highest vs. lowest adherers ) . Conclusion : The present study does , thus , not support a previous finding of an inverse association between a healthy Nordic food index and colorectal cancer . Impact : This article adds new evidence to the field of the Nordic diet in disease prevention . Cancer Epidemiol Biomarkers Prev ; 24(4 ) ; 755–7 . © 2015 AACR

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial.

The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD . However , the extent of food changes needed to achieve these effects is less explored . The aim of the present study was to investigate the effects of exchanging a few commercially available , regularly consumed key food items ( e.g. spread on bread , fat for cooking , cheese , bread and cereals ) with improved fat quality on total cholesterol , LDL-cholesterol and inflammatory markers in a double-blind r and omised , controlled trial . In total , 115 moderately hypercholesterolaemic , non-statin-treated adults ( 25 - 70 years ) were r and omly assigned to an experimental diet group ( Ex-diet group ) or control diet group ( C-diet group ) for 8 weeks with commercially available food items with different fatty acid composition ( replacing SFA with mostly n-6 PUFA ) . In the Ex-diet group , serum total cholesterol ( P<0·001 ) and LDL-cholesterol ( P<0·001 ) were reduced after 8 weeks , compared with the C-diet group . The difference in change between the two groups at the end of the study was -9 and -11 % in total cholesterol and LDL-cholesterol , respectively . No difference in change in plasma levels of inflammatory markers ( high-sensitive C-reactive protein , IL-6 , soluble TNF receptor 1 and interferon-γ ) was observed between the groups . In conclusion , exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol , with no negative effect on levels of inflammatory markers . This shows that an exchange of a few commercially available food items was easy and manageable and led to clinical ly relevant cholesterol reduction , potentially affecting future CVD risk

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial

Background / Objectives : Short-term studies have suggested beneficial effects of a Palaeolithic-type diet ( PD ) on body weight and metabolic balance . We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women , in comparison with a diet according to the Nordic Nutrition Recommendations (NNR).Subjects/ Methods : Seventy obese postmenopausal women ( mean age 60 years , body mass index 33 kg/m2 ) were assigned to an ad libitum PD or NNR diet in a 2-year r and omized controlled trial . The primary outcome was change in fat mass as measured by dual-energy X-ray absorptiometry . Results : Both groups significantly decreased total fat mass at 6 months ( −6.5 and −2.6 kg ) and 24 months ( −4.6 and −2.9 kg ) , with a more pronounced fat loss in the PD group at 6 months ( P<0.001 ) but not at 24 months ( P=0.095 ) . Waist circumference and sagittal diameter also decreased in both the groups , with a more pronounced decrease in the PD group at 6 months ( −11.1 vs−5.8 cm , P=0.001 and −3.7 vs−2.0 cm , P<0.001 , respectively ) . Triglyceride levels decreased significantly more at 6 and 24 months in the PD group than in the NNR group ( P<0.001 and P=0.004 ) . Nitrogen excretion did not differ between the groups . Conclusions : A PD has greater beneficial effects vs an NNR diet regarding fat mass , abdominal obesity and triglyceride levels in obese postmenopausal women ; effects not sustained for anthropometric measurements at 24 months . Adherence to protein intake was poor in the PD group . The long-term consequences of these changes remain to be studied

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

[Food intake of Danes and cardiac risk factors].

We served a low-fat ( 28 % of energy ) high-fibre ( 3.3 g/MJ ) diet according to Nordic Nutrition Recommendations ( REC diet ) , and a high-fat diet ( 39 % of energy ) corresponding to the average Danish diet ( DANE diet ) to 21 healthy middle-aged individuals in a two times two weeks cross-over study . The REC diet result ed in lower serum concentrations of low density lipoprotein ( LDL ) cholesterol ( medians : 2.77 vs 3.04 mmol/l , p < 0.001 ) , and high-density lipoprotein ( HDL ) cholesterol ( 1.08 vs 1.24 mmol/l , p < 0.001 ) , and higher fasting triglycerides ( 1.11 vs 0.86 mmol/l , p = 0.04 ) than the DANE diet . Furthermore , the REC diet lowered plasma factor VII coagulant activity ( FVIIc ) ( 88 vs 96 % , p = 0.002 ) and raised plasma fibrinolytic activity . Our observations indicate that a low-fat high-fibre diet may not only reduce the atherogenic , but also the thrombogenic tendency of an individual compared with a diet corresponding to the average Danish diet

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Design of the OPUS School Meal Study: A randomised controlled trial assessing the impact of serving school meals based on the New Nordic Diet

Introduction : Danish children consume too much sugar and not enough whole grain , fish , fruit , and vegetables . The Nordic region is rich in such foods with a strong health-promoting potential . We lack r and omised controlled trials that investigate the developmental and health impact of serving school meals based on Nordic foods . Aim : This paper describes the rationale , design , study population , and potential implication s of the Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ( OPUS ) School Meal Study . Methods : In a cluster-r and omised cross-over design , 1021 children from 3rd and 4th grade s ( 8–11 years old ) at nine Danish municipal schools were invited to participate . Classes were assigned to two 3-month periods with free school meals based on the New Nordic Diet ( NND ) or their usual packed lunch ( control ) . Dietary intake , nutrient status , physical activity , cardiorespiratory fitness , sleep , growth , body composition , early metabolic and cardiovascular risk markers , illness , absence from school , wellbeing , cognitive function , social and cultural features , food acceptance , waste , and cost were assessed . Results : In total , 834 children ( 82 % of those invited ) participated . Although their parents were slightly better educated than the background population , children from various socioeconomic background s were included . The proportion of overweight and obese children ( 14 % ) resembled that of earlier examinations of Danish school children . Drop out was 8.3 % . Conclusions : A high inclusion rate and low drop out rate was achieved . This study will be the first to determine whether school meals based on the NND improve children ’s diet , health , growth , cognitive performance , and early disease risk markers

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET).

OBJECTIVE the aim of this study was to investigate the effects of a healthy Nordic diet ( ND ) on cardiovascular risk factors . DESIGN AND SUBJECTS in a r and omized controlled trial ( NORDIET ) conducted in Sweden , 88 mildly hypercholesterolaemic subjects were r and omly assigned to an ad libitum ND or control diet ( subjects ' usual Western diet ) for 6 weeks . Participants in the ND group were provided with all meals and foods . Primary outcome measurements were low-density lipoprotein ( LDL ) cholesterol , and secondary outcomes were blood pressure ( BP ) and insulin sensitivity ( fasting insulin and homeostatic model assessment -insulin resistance ) . The ND was rich in high-fibre plant foods , fruits , berries , vegetables , whole grains , rapeseed oil , nuts , fish and low-fat milk products , but low in salt , added sugars and saturated fats . RESULTS the ND contained 27 % , 52 % , 19 % and 2 % of energy from fat , carbohydrate , protein and alcohol , respectively . In total , 86 of 88 subjects r and omly assigned to diet completed the study . Compared with controls , there was a decrease in plasma cholesterol ( -16 % , P < 0.001 ) , LDL cholesterol ( -21 % , P < 0.001 ) , high-density lipoprotein ( HDL ) cholesterol ( -5 % , P < 0.01 ) , LDL/HDL ( -14 % , P < 0.01 ) and apolipoprotein (apo)B/apoA1 ( -1 % , P < 0.05 ) in the ND group . The ND reduced insulin ( -9 % , P = 0.01 ) and systolic BP by -6.6 ± 13.2 mmHg ( -5 % , P < 0.05 ) compared with the control diet . Despite the ad libitum nature of the ND , body weight decreased after 6 weeks in the ND compared with the control group ( -4 % , P < 0.001 ) . After adjustment for weight change , the significant differences between groups remained for blood lipids , but not for insulin sensitivity or BP . There were no significant differences in diastolic BP or triglyceride or glucose concentrations . CONCLUSIONS a healthy ND improves blood lipid profile and insulin sensitivity and lowers blood pressure at clinical ly relevant levels in hypercholesterolaemic subjects

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .

Plasma alkylresorcinols reflect important whole-grain components of a healthy Nordic diet.

Biomarkers of dietary intake can be important tools in nutrition research . Our aim was to assess whether plasma alkylresorcinol ( AR ) and β-carotene concentrations could be used as dietary biomarkers for whole-grain , fruits and vegetables in a healthy Nordic diet ( ND ) . Participants ( n = 166 ) , 30 - 65 y with a body mass index of 27 - 40 kg/m(2 ) and two more features of metabolic syndrome ( International Diabetes Federation definition , slightly modified ) , were recruited through six centers in the Nordic countries and r and omly assigned to an ND or control diet for 18 or 24 wk , depending on study center . Plasma AR and β-carotene were analyzed and nutrient intake calculated from 4-d food records . Median fiber intake increased in the ND group from 2.5 g/MJ at baseline to 4.1 g/MJ ( P < 0.001 ) at end point ( week 18 or 24 ) , and median ( IQR ) fasting plasma total AR concentration increased from 73 ( 88 ) to 106 ( 108 ) nmol/L , or 45 % , from baseline to end point ( P < 0.001 ) . The AR concentration was significantly higher in the ND group ( P < 0.001 ) than in the control group at end point . β-Carotene intake tended to increase in the ND group ( P = 0.07 ) , but the plasma β-carotene concentration did not change significantly throughout the study and did not differ between the groups at follow-up . In conclusion , an ND result ed in higher dietary fiber intake and increased plasma total AR concentration compared with the control diet , showing that the total AR concentration might be a valid biomarker for an ND in which whole-grain wheat and rye are important components . No significant difference in plasma β-carotene concentrations was observed between the ND and control groups , suggesting that β-carotene may not be a sensitive enough biomarker of the ND

Conclusion The Nordic dietary pattern improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern

Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers . Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .