Statins advised for more than 40 years even without Cardiovascular Disease

This recommendation statement from the U.S. Preventive Services Task Force (USPSTF) updates its 2008 guideline on screening for and treatment of dyslipidemia in adults without known cardiovascular (CV) disease. Based on a review of 19 randomized controlled trials that involved more than 71,000 patients, the updated recommendations are somewhat similar to those in four other major guidelines on statin use that have been published during the last 3 years, including the American College of Cardiology/American Heart Association (ACC/AHA) guideline (NEJMJW Gen Med Dec 15 2013 and J Am Coll Cardiol 2014; 63:2889). These recommendations do not apply to patients who have LDL cholesterol levels >190 mg/dL or known familial hypercholesterolemia.

Key Points
• For primary prevention of CV disease, a low- to moderate-dose statin should be considered for middle-aged adults (age range, 40–75) without known CV disease who have at least one traditional risk factor for CV disease (i.e., dyslipidemia, diabetes, hypertension, or smoking) and a 10-year risk for developing CV disease of ≥10% calculated using the ACC/AHA Pooled Cohort Equations (http://www.acc.org/tools-and-practice-support/ mobile-resources/features/2013-prevention-guidelines-ascvd-risk-estimator) (B recommendation).
• A low- to moderate-dose statin might be considered for middle-aged adults without known CV disease who have at least one traditional risk factor for CV disease and a 10-year risk for developing CV disease of 7.5% to 10%(C recommendation).
• Current evidence is insufficient to make a recommendation about initiating statin use in older patients (age, ≥76).