TY - CHAP M1 - Book, Section TI - Therapeutic Effects of Lowering Cholesterol A1 - Blaha, Michael J. A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. A2 - McQuaid, Kenneth R. PY - 2023 T2 - Current Medical Diagnosis & Treatment 2023 AB - Reducing cholesterol levels in healthy middle-aged men without CHD (in primary prevention studies) reduces risk in direct proportion to the reduction in LDL cholesterol. Treated adults have clinically important reductions in the rates of MIs, new cases of angina, need for coronary artery bypass or other revascularization procedures, peripheral artery disease, and stroke. The West of Scotland Study showed a 31% decrease in MIs in middle-aged men treated with pravastatin compared with placebo. The Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) study showed similar results with lovastatin. As with any primary prevention interventions, large numbers of healthy patients need to be treated to prevent a single event. The numbers of patients needed to treat (NNT) to prevent one nonfatal MI or one CAD death in these two studies were 46 and 50, respectively. The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) study of atorvastatin in persons with hypertension and other risk factors but without CHD demonstrated a 36% reduction in CHD events. The Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) study showed a 44% reduction in a combined end point of MI, stroke, revascularization, hospitalization for unstable angina, or death from cardiovascular causes in both men and women. The NNT for 1 year to prevent one event was 169. The Heart Outcomes Prevention Evaluation (HOPE-3) trial of rosuvastatin showed a 24% reduction in cardiovascular events. The NNT over 5.6 years was 91. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1193133419 ER -