Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease

In one comparison from a 2-by-2 factorial trial, 12,705 persons at intermediate cardiovascular risk were assigned to either rosuvastatin or placebo. At 5.6 years, there were significantly fewer participants with cardiovascular events in the rosuvastatin group than in the placebo group. Cardiovascular diseases cause 18 million deaths per year globally and a similar number of nonfatal cardiovascular events. 1 Elevated low-density lipoprotein (LDL) cholesterol levels account for approximately half the population-attributable risk of myocardial infarction 2 and approximately one quarter of the risk of ischemic stroke. 3 In previous trials, lowering LDL cholesterol levels with statins has been shown to reduce the risk of cardiovascular diseases, but most of the patients enrolled in those trials had vascular disease, elevated lipid levels, elevated inflammatory markers, hypertension, or diabetes. 4 , 5 The association between LDL cholesterol level and cardiovascular disease is graded and has no documented threshold. . . .