HMG CO-A reductase inhibitor treatment in the prevention of coronary heart disease
Milne R
Record ID 31998008890
English
Authors' objectives:
Raised blood cholesterol increases people's risk of heart disease. This report considers the role of statins (a new class of drugs which lower cholesterol levels) in both the secondary and the primary prevention of heart disease (i.e. in people respectively with and without clinical evidence of pre-existing disease).
Authors' results and conclusions:
Both drugs were shown to reduce cholesterol levels. Simvastatin was associated with a significant reduction of about 30% in both coronary events and in all cause mortality. Pravastatin was associated with a significant reduction in coronary events of about 30% and a reduction in all cause mortality of about 20% (borderline significance). However the data say little about the benefit in women (who made up 19% of patients in the first study and none in the second study) and nothing about older people (neither study looked at those over 70).
Authors' recommendations:
The author recommends the use of statins for secondary prevention, but considers that the case for primary prevention is marginal. It is stressed that statins should only be used as part of the overall management of coronary heart disease, and that risk assessment should be based on a number of factors, including cholesterol, smoking, blood pressure, family history, and lifestyle. It is important that the risks and benefits of statins are discussed with individual patients, bearing in mind their baseline risk and opportunities for non-pharmacologic intervention.
Authors' methods:
Review
Details
Project Status:
Completed
URL for project:
http://www.wihrd.soton.ac.uk
Year Published:
1997
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England
MeSH Terms
- Coronary Disease
- Costs and Cost Analysis
- Anticholesteremic Agents
- Hypercholesterolemia
Contact
Organisation Name:
Wessex Institute for Health Research and Development
Contact Address:
Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662
Copyright:
Wessex Institute for Health Research and Development (WIHRD)
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