Role of statins in primary prevention of cardiovascular disease
Keywords:Statin, Primary, Prevention, Cardiovascular, Disease
Cardiovascular disease continues to remain a global health challenge due to its increasing trend of prevalence. Almost, 6.2 million deaths were caused by cardiovascular diseases among patients of age range 30-70 years in 2019. The burden of cardiovascular diseases can only be reduced by implementation of effective preventive strategies. Primary prevention is of utmost importance since individuals at risk are treated beforehand thus reducing the chance of development of disease. Statins are lipid lowering agents and are used in primary prevention of cardiovascular disease. The purpose of this research is to review the available information about role of statins in primary prevention of cardiovascular disease. Generally, statins are considered as safe and effective medications to treat and reduce the morbidity of cardiovascular diseases. The relative risk of coronary events, cardiovascular disease mortality, non-fatal strokes, and all-cause mortality is decreased with statin therapy. Elderly population or individuals at risk of development of cardiovascular diseases can be efficiently managed by statin therapy. Some studies associate the occurrence of diabetes with the use of statins but most of the studies recommend the role of statins in prevention as benefits outweigh the risks. Literature also supports the role of statins in primary prevention although more clinical studies in future can yield better evidence-based results to support the use of statins especially in primary prevention.
Flora GD, Nayak MK. A Brief Review of Cardiovascular Diseases, Associated Risk Factors and Current Treatment Regimes. Curr Pharm Design. 2019;25(38):4063-84.
Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021.
Byrne P, Cullinan J, Smith A, Smith SM. Statins for the primary prevention of cardiovascular disease: an overview of systematic reviews. BMJ Open. 2019;9(4):e023085.
Hope HF, Binkley GM, Fenton S, Kitas GD, Verstappen SMM, Symmons DPM. Systematic review of the predictors of statin adherence for the primary prevention of cardiovascular disease. PloS One. 2019;14(1):e0201196.
Minder CM, Blumenthal RS, Blaha MJ. Statins for primary prevention of cardiovascular disease: the benefits outweigh the risks. Curr Opinion Cardiol. 2013;28(5):554-60.
Singh BM, Lamichhane HK, Srivatsa SS, Adhikari P, Kshetri BJ, Khatiwada S, Shrestha DB. Role of Statins in the Primary Prevention of Atherosclerotic Cardiovascular Disease and Mortality in the Population with Mean Cholesterol in the Near-Optimal to Borderline High Range: A Systematic Review and Meta-Analysis. Adv Prev Med. 2020;2020:6617905.
Taylor F, Huffman MD, Macedo AF, Moore TH, Burke M, Davey Smith G, Ward K, Ebrahim S. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;2013(1):CD004816.
Strandberg TE. Role of Statin Therapy in Primary Prevention of Cardiovascular Disease in Elderly Patients. Curr Atherosclerosis Rep. 2019;21(8):28.
Enas EA, Kuruvila A, Khanna P, Pitchumoni CS, Mohan V. Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians - a population with the highest risk of premature coronary artery disease & diabetes. Indian J Med Res. 2013;138(4):461-91.
Reiner Ž. Statins in the primary prevention of cardiovascular disease. Nature Rev Cardiol. 2013;10(8):453-64.
Teng M, Lin L, Zhao YJ, Khoo AL, Davis BR, Yong QW, Yeo TC, Lim BP. Statins for Primary Prevention of Cardiovascular Disease in Elderly Patients: Systematic Review and Meta-Analysis. Drugs Aging. 2015;32(8):649-61.
Zhou Z, Curtis AJ, Ernst ME, Ryan J, Zoungas S, Wolfe R, McNeil JJ, Murray AM, Reid CM, Chowdhury EK, Woods RL, Tonkin AM, Nelson MR. Comparison of statins for primary prevention of cardiovascular disease and persistent physical disability in older adults. Eur J Clin Pharmacol. 2022;78(3):467-76.
Garcia-Gil M, Comas-Cufí M, Blanch J, Martí R, Ponjoan A, Alves-Cabratosa L, et al. Effectiveness of Statins as Primary Prevention in People With Different Cardiovascular Risk: A Population-Based Cohort Study. Clin Pharmacol Ther. 2018;104(4):719-32.
Lavie G, Hoshen M, Leibowitz M, Benis A, Akriv A, Balicer R, Reges O. Statin Therapy for Primary Prevention in the Elderly and Its Association with New-Onset Diabetes, Cardiovascular Events, and All-Cause Mortality. Am J Med. 2021;134(5):643-52.
Tonelli M, Lloyd A, Clement F, Conly J, Husereau D, Hemmelgarn B, et al. Efficacy of statins for primary prevention in people at low cardiovascular risk: a meta-analysis. CMAJ. 2011;183(16):E1189-202.
Sigglekow F, Horsburgh S, Parkin L. Statin adherence is lower in primary than secondary prevention: A national follow-up study of new users. PloS One. 2020;15(11):e0242424.
Yebyo HG, Aschmann HE, Kaufmann M, Puhan MA. Comparative effectiveness and safety of statins as a class and of specific statins for primary prevention of cardiovascular disease: A systematic review, meta-analysis, and network meta-analysis of randomized trials with 94,283 participants. Am Heart J. 2019;210:18-28.
Kazi DS, Penko JM, Bibbins-Domingo K. Statins for Primary Prevention of Cardiovascular Disease: Review of Evidence and Recommendations for Clinical Practice. Med Clin North Am. 2017;101(4):689-99.