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January 2017

Statins for Primary Prevention: The Debate Is Intense, but the Data Are Weak

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2Editor, JAMA Internal Medicine
  • 3County of Los Angeles, Department of Health Services, Los Angeles, California
  • 4Deputy Editor, JAMA Internal Medicine
JAMA Intern Med. 2017;177(1):21-23. doi:10.1001/jamainternmed.2016.7585

A recent issue of JAMA contains the latest US Preventive Services Task Force (USPSTF) recommendation statement on statins for prevention of cardiovascular disease in adults,1 along with the accompanying evidence report and systematic review2 on which the recommendations are based. The evidence report summarized data from 19 trials including a total of 71 344 patients and concluded that statin therapy was associated with reduced risk of all-cause and cardiovascular mortality and cardiovascular disease (CVD) events. Thus, the task force recommended “initiating use of low- to moderate-dose statins in adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors and a calculated 10-year CVD event risk of 10% or greater (B recommendation)” or “7.5% to 10% (C recommendation).”1 Although the task force did their usual careful job of reviewing the evidence, the evidence for treating asymptomatic persons with statins does not appear to merit a grade B or even a grade C recommendation.

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