Evidence Summary

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Statins reduce mortality, cardiovascular disease, coronary heart disease, and stroke in people with no history of cardiovascular disease

Taylor F, Huffman MD, Macedo AF, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013(1):CD004816.

Review question

What are the effects of statins in people with no history of cardiovascular disease?


Cardiovascular disease refers to diseases that involve the heart and the system of arteries, veins, and vessels that carry blood throughout the body.

High blood cholesterol increases the chances of cardiovascular disease events such as chest pain, heart attacks, or strokes.

Reducing high blood cholesterol is an important goal of treatment with medications. Statins are a group of cholesterol-lowering drugs. They are a first choice for this purpose.

How the review was done

This is an update of a 2007 systematic review.

The systematic review included 18 randomized controlled trials of 56,934 people who were 28 to 97 years of age (average age 57 years, 60% men).

Pharmaceutical companies fully or partially funded trials. Risk of bias was low.

Outcomes included mortality from all causes, fatal and nonfatal coronary heart disease, cardiovascular disease and stroke, restoration of blood circulation, change in total and LDL (or “bad”) cholesterol, adverse effects, quality of life, and costs.

People were followed up for 1 to 5 years.

What the researchers found

Compared with placebo, statins

  • reduced all-cause mortality by 14%
  • reduced fatal plus nonfatal cardiovascular disease by 25%
  • reduced fatal plus nonfatal coronary heart disease events by 27%
  • reduced fatal plus nonfatal stroke by 22%
  • reduced the need for procedures to restore blood circulation by 38%
  • reduced total cholesterol and LDL cholesterol in all trials, but the effect varied across trials

Statins caused no harms.


Statins reduce all-cause mortality, major vascular events, and need for procedures to restore blood circulation in people with no history of cardiovascular disease.


Coronary heart disease
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
A harmless, inactive, and simulated treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Risk of bias
Possibility of some systematic error in the studies.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.

Related Web Resources

  • Coronary artery disease risk screening

    Health Link B.C.
    Men over 40 and women past menopause or over 50 should get screened for coronary artery disease (CAD) every 1 to 3 years. Your risk is higher if you have diabetes, high blood pressure, abdominal obesity, kidney disease, family history of CAD or if you smoke.
  • High cholesterol: Does reducing the amount of fat in your diet help?

    Informed Health Online
    Eat less saturated fats in your diet to help prevent heart disease. Eat less meat, butter, cheese and cream to improve your health long-term.
  • Statins: Should I Take Them to Prevent a Heart Attack or Stroke?

    This patient decision aid helps people considering taking medicines called statins to lower their risk of heart attack and stroke by comparing the benefits, risks, and side effects of both options. It also includes alternative treatment options to taking statins such as trying to lower risk with lifestyle changes.
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