The US Preventive Services Task Force (USPSTF) has issued final recommendations on the use of statins for primary prevention of cardiovascular disease (CVD) in adults.

The following recommendations apply only to individuals without a history of CVD and who are not already taking statins:

  • For adults 40 to 75 years of age who have 1 or more cardiovascular risk factors (eg, dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year CVD risk of 10% or greater: a statin should be prescribed for primary prevention (Grade B [recommended]).
  • For adults 40 to 75 years of age who have 1 or more cardiovascular risk factors and an estimated 10-year CVD risk of 7.5% to less than 10%: while the likelihood of benefit is smaller in this patient population, clinicians should selectively offer a statin for primary prevention (Grade C [recommendation depends on the patient’s situation]).
  • For adults 76 years of age and older: there is insufficient evidence on the benefits and harms of using statins for primary prevention (Grade I [balance of benefits and harms cannot be determined]).

The final recommendations were based on a review of evidence from 26 studies. Results showed that statins were significantly associated with a reduced risk for all-cause mortality (risk ratio [RR], 0.92 [95% CI, 0.87-0.98]), stroke (RR, 0.78 [95% CI, 0.68-0.90], myocardial infarction (RR, 0.67 [95% CI, 0.60-0.75], and composite cardiovascular outcomes (RR, 0.72 [95% CI, 0.64-0.81]), though the association with cardiovascular mortality was not found to be statistically significant (RR, 0.91 [95% CI, 0.81-1.02]).

Findings also demonstrated that the benefits of statin use appeared similar in subgroups defined by demographic characteristics (eg, sex, race, and ethnicity) and clinical characteristics (eg, diabetes, kidney dysfunction). Evidence on the benefits of statin therapy for older patients was found to be limited.

With regard to potential harms, statins were not associated with increased risks for serious adverse events, cancer, elevated liver enzymes, muscle-related harms, or diabetes.

Reference

US Preventive Services Task Force. Task Force issues final recommendation statement on statin use for the primary prevention of cardiovascular disease in adults. News release. US Preventive Services Task Force. Accessed August 23, 2022. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/statin-use-cvd-prevention-final-rec-bulletin.pdf