The U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation statement regarding the use of statins in the primary prevention of cardiovascular disease (CVD) in adults. This recommendation replaces the one from 2008, based on accumulating evidence on the role of statins in primary CVD prevention across different populations.
The new draft statement recommends that adult patients aged 40–75 years who have one or more CVD risk factors (ie, dyslipidemia, diabetes, hypertension, smoking) and a calculated 10-year CVD event risk of ≥10% should receive a low- to moderate-dose statin for the prevention of CVD events. This is a Grade B recommendation, meaning there is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.
For adult patients 40–75 years with one or more CVD risk factors and a calculated 10-year CVD event risk of 7.5% to 10%, clinicians may choose to offer a low- to moderate-dose statin to certain adults without a history of CVD. The likelihood of benefit however is smaller due to lower probability of disease and uncertainty in individual risk prediction. While regular statin use may reduce CVD risk in patients where predicted 10-year risk is less than 10%, the number of individuals who will avert a CVD event is smaller than for those with >10% risk. Patients at lower risk who value the potential benefits over the potential harms and who do not mind taking a daily medication may wish to initiate statin therapy for CVD risk reduction. This is a Grade C recommendation, meaning that providing treatment is based on individual judgement and patient preferences. There is at least moderate certainty that the benefit is small.