- Share - [](https://www.facebook.com/sharer.php?u=https://about.ebsco.com/markdownify/node/86475) - []() - []() - []() # Investigating the Status of Statins for Primary Prevention of Cardiovascular Disease This article is part one of a four-part series devoted to making sense of statins for primary prevention of cardiovascular disease from clinician-scientist Dr. Martin (Marty) Mayer at DynaMed Decisions. ![](https://assets.ebsco.com/asset/470fbe35-bac3-40d4-8bad-0531120f9478/Statins-for-Primary-Prevention-of-CVD-blog-image-780-1.png) [Martin Mayer, DMSc, MS, PA-C](/health-notes/bio/martin-mayer-dmsc-ms-pa-c) 8 February 2024 Statins. It seems there’s always something abuzz with respect to this class of medications, even though the first medication in this class was approved over three decades ago. Major guideline recommendations are fairly consistent regarding statin therapy for *secondary prevention* of cardiovascular outcomes. Unfortunately, the same cannot be said for *primary prevention* in patients who do not have cardiovascular disease. The 2018 guidelines from the [American College of Cardiology](https://www.sciencedirect.com/science/article/pii/S073510971839034X?via%3Dihub) and [American Heart Association](https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625) (ACC-AHA) give recommendations for different statin intensities based on various clinical factors. In contrast, the 2022 guidelines from the [United States Preventive Services Taskforce](https://doi.org/10.1001/jama.2022.13044) (USPSTF) say moderate-intensity statin therapy seems reasonable for most people who are taking a statin for primary prevention, but this is not a formal recommendation. This statement seems to be informed by observations from an accompanying [systematic review and meta-analysis](https://www.ncbi.nlm.nih.gov/books/NBK583661/) (SRMA), which explains important details pertaining to evidence about statins for primary prevention: - There are limited data directly comparing differing statin intensities for primary prevention. - Most primary prevention trials studied moderate-intensity statin therapy only. - There is no clear dose-response effect for statin intensity and efficacy. It is also worth noting the Cholesterol Treatment Trialists (CTT) have – since 2005 and intermittently thereafter – published individual patient data meta-analyses (IPDMAs) that offer estimates of cardiovascular risk reduction from statins per mmol/L (≈ 40 mg/dL, but more precisely ≈ 38.7 mg/dL) reduction in LDL-C. **So, what does this mean for statins in primary prevention?** Well, it’s complicated. But don’t turn away just yet. It’s a fun and interesting kind of complicated, and one that – when the dust settles – may offer clarity. In the weeks to come, we’ll cover the [CTT IPDMAs](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-0), the [USPSTF SRMA](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-1), and finally, a [reflection and synthesis](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-2) that may help to make all this talk about statins more understandable and implementable as we strive to provide the best possible care. ### Log in to DynaMed Decisions [ Statins for Primary Prevention of Cardiovascular Disease ](https://decisions.dynamed.com/tools/statins-for-primary-prevention-of-cardiovascular-disease) Category: [Clinical Practice Perspectives ](/blogs/health-notes/category/clinical-practice-perspectives) Tags: [Evidence–based medicine](/blogs/health-notes/tag/evidence–based-medicine) [Clinical decision support](/blogs/health-notes/tag/clinical-decision-support) - Share - [](https://www.facebook.com/sharer.php?u=https://about.ebsco.com/markdownify/node/86475) - []() - []() - []() ## Related Posts [ ![](https://assets.ebsco.com/asset/0cabea64-c2ea-45ed-b562-5fa7be35f472/Statins-for-Primary-Prevention-of-CVD-blog-image-780-2.png) ](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-0) [Investigating the Status of Statins for Primary Prevention of Cardiovascular Disease](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-0) 15 February 2024 [ ![](https://assets.ebsco.com/asset/3fcf15a0-a0bb-48f5-9227-d866a88b32e4/Statins-for-Primary-Prevention-of-CVD-blog-image-780-3.png) ](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-1) [Investigating the Status of Statins for Primary Prevention of Cardiovascular Disease](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-1) 22 February 2024 [ ![](https://assets.ebsco.com/asset/390a648f-b5c6-4675-85a1-d536201b4d08/Statins-for-Primary-Prevention-of-CVD-blog-image-780-4.png) ](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-2) [Investigating the Status of Statins for Primary Prevention of Cardiovascular Disease](/blogs/health-notes/investigating-status-statins-primary-prevention-cardiovascular-disease-2) 29 February 2024