Statins for people at low risk of cardiovascular disease

摘要

The Cholesterol Treatment Trial ists' (CTT) meta-analysis reports a relative risk reduction with statins of about 20% for major vascular events per 1 mmol/L reduction in LDL cholesterol, and more in those with a baseline 5-year risk of major vascular events of less than 5%.However, some major vascular events in randomised controlled trials of statins can be subjective. Indeed, loss of blinding to treatment allocation probably occurs in such trials, because statins predictably lower LDL cholesterol, and the individuals who manage the patients know the lipid variables.2 Loss of blinding probably biases decisions about revascularisation procedures, and, in the statin groups, loss of blinding would result in fewer myocardial infarctions secondary to these procedures.