# Statins

Drug · id `cardio:statins` · Cardiovascular Atlas · release `5dcd9b263fe17744` (public)

> General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here.

The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations.

Also called: HMG-CoA reductase inhibitors

Browse, condition area: Risk and prevention; Coronary and vascular disease  

## In plain language

Statins are the most common medicines used to treat high cholesterol. They lower LDL cholesterol by slowing down how much cholesterol the liver makes. Most of the other cholesterol medicines in this atlas were tested on top of a statin; one other medicine was tested in people who could not take one.

## Technical summary

Drug class (HMG-CoA reductase inhibitors). The evidence recorded is the Cholesterol Treatment Trialists meta-analysis of 26 randomised statin trials (2010), with its rates per 1.0 mmol/L of LDL lowering. No individual statin has its own record yet. The trials of ezetimibe and the PCSK9 antibodies in this atlas were run on a statin background; one trial of another cholesterol medicine enrolled statin-intolerant people.

## Claims, with the population each applies to

## Context: Adults with type 1 or type 2 diabetes and CKD (ADA/KDIGO 2022 consensus report)

Recipient: Adult; Population: Adults with type 1 or type 2 diabetes and chronic kidney disease (CKD). The report defines CKD as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2, albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) or other signs of kidney damage that persist for at least 3 months. It gives no age limit.; Care setting: Not stated in the report.; Geography: Not stated in the report (a joint report of a US association and an international kidney organization); Life stage: Adults, as the report's introduction puts it (adults with diabetes and CKD); the report gives no age bounds; Follow-up: Not applicable (guidance context)

### The ADA/KDIGO consensus report recommends a statin for everyone with type 1 or type 2 diabetes and CKD. The dose is of moderate intensity to prevent a first atherosclerotic cardiovascular event, and of high intensity for people who already have such disease and for some people who have several risk factors for it.

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Adult; Population: Adults with type 1 or type 2 diabetes and chronic kidney disease (CKD). The report defines CKD as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2, albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) or other signs of kidney damage that persist for at least 3 months. It gives no age limit.; Care setting: Not stated in the report.; Geography: Not stated in the report (a joint report of a US association and an international kidney organization); Life stage: Adults, as the report's introduction puts it (adults with diabetes and CKD); the report gives no age bounds; Follow-up: Not applicable (guidance context)
- Limitations: The report's text notes a possible exception: people whose kidney failure is treated with dialysis, in whom a statin started to prevent a first event has generally been ineffective. It endorses the ADA's wider advice on adding other lipid-lowering medicines but does not make it a consensus statement. Only the PubMed record and the PMC full text were read. The report is joint ADA and KDIGO guidance drawn from the two organizations' 2022 guidelines, not a trial result, and its consensus statements carry no class of recommendation or level of evidence (the report points to the two organizations' own documents for those). It dates from 2022, so later trials and approvals are not covered. Its licence allows educational, not-for-profit use of the unaltered work, so this atlas restates the statement in its own words. PubMed lists no correction to the report (checked 2026-10-15).
- Last checked: 2026-10-15
- Sources:
  1. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) <https://doi.org/10.2337/dci22-0027>
     Locator: Lipid Management, Consensus Statement. Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7.
     How it applies: The consensus statement on a statin.
  2. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) <https://doi.org/10.2337/dci22-0027>
     Locator: Lipid Management, para 2 (dialysis exception). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7.
     How it applies: Possible exception for people on dialysis.
  3. Supports: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) <https://doi.org/10.2337/dci22-0027>
     Locator: Lipid Management, para 1 (ADA advice endorsed). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7.
     How it applies: The ADA's wider lipid advice is endorsed.
  4. Background: Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) (Guideline, edition Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.) <https://doi.org/10.2337/dci22-0027>
     Locator: Introduction, para 4 (level of evidence). Retrieved 2026-10-15T15:38:41Z. Source state: Current. Snapshot hash: 18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7.
     How it applies: The consensus statements carry no level of evidence.

## Context: Participants of large randomised statin trials in the Cholesterol Treatment Trialists individual-participant meta-analysis (2010)

Recipient: Recipient not specified; Population: Participants of randomised trials of statin regimens with at least 1000 participants and at least 2 years of treatment: five trials of more versus less intensive statin therapy (39 612 people) and 21 trials of statin versus control (129 526 people). Ages and conditions are not given in the abstract.; Care setting: Not stated in the source (abstract only); Geography: Not stated in the source (abstract only); Life stage: Not stated in the abstract; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Median follow-up 5.1 years in the more-versus-less-intensive trials and 4.8 years in the statin-versus-control trials, as the abstract reports.

### An analysis that pooled the data of individual participants from 26 randomised statin trials (about 170,000 participants) found that each 1.0 mmol/L lowering of LDL cholesterol was linked to fewer major vascular events (rate ratio 0.78, 95% CI 0.76 to 0.80) and lower all-cause mortality (rate ratio 0.90, 95% CI 0.87 to 0.93). In the five trials of more versus less intensive statin therapy, a further 0.51 mmol/L LDL reduction at 1 year went with a 15% further reduction in major vascular events (95% CI 11 to 18). The abstract reports no significant effect on cancer incidence (rate ratio 1.00, 95% CI 0.96 to 1.04) and says no threshold was seen within the range studied.

- Category: Effect
- Evidence stage: Evidence synthesis
- Certainty: Certainty not assessed
- Applies to: Recipient: Recipient not specified; Population: Participants of randomised trials of statin regimens with at least 1000 participants and at least 2 years of treatment: five trials of more versus less intensive statin therapy (39 612 people) and 21 trials of statin versus control (129 526 people). Ages and conditions are not given in the abstract.; Care setting: Not stated in the source (abstract only); Geography: Not stated in the source (abstract only); Life stage: Not stated in the abstract; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Median follow-up 5.1 years in the more-versus-less-intensive trials and 4.8 years in the statin-versus-control trials, as the abstract reports.
- Limitations: Abstract only. This is a pooled analysis by the trialists, funded by public and charitable bodies according to the abstract, of trials of statin regimens, so it says nothing about other LDL-lowering medicines. Effects are per unit of LDL lowering. The abstract does not give the ages or conditions of the participants.
- Last checked: 2026-10-14
- Sources:
  1. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: ArticleTitle: "Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Abstract of the paper from PubMed; the full text was not read.
  2. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, METHODS, sentence 1, fragment 2 of 3: "versus less intensive statin regimens (five trials; 39 612 individuals; median follow-up 5·1 years) and of statin versus control (21 trials; 129 526 individuals;". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Trial and participant counts, more versus less intensive and statin versus control.
  3. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, METHODS, sentence 1, fragment 3 of 3: "median follow-up 4·8 years).". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Median follow-up of the statin-versus-control trials.
  4. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, FINDINGS, sentence 1: "In the trials of more versus less intensive statin therapy, the weighted mean further reduction in LDL cholesterol at 1 year was 0·51 mmol/L.". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Further LDL reduction at 1 year in the more-intensive trials.
  5. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, FINDINGS, sentence 2, fragment 1 of 3: "Compared with less intensive regimens, more intensive regimens produced a highly significant 15% (95% CI 11-18; p&lt;0·0001) further reduction in major vascular events,". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Further reduction in major vascular events with more intensive regimens.
  6. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, FINDINGS, sentence 4, fragment 2 of 3: "types of patient studied (rate ratio \[RR\] 0·78, 95% CI 0·76-0·80; p&lt;0·0001),". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Rate ratio per 1.0 mmol/L for major vascular events.
  7. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, FINDINGS, sentence 5, fragment 1 of 4: "Across all 26 trials, all-cause mortality was reduced by 10% per 1·0 mmol/L LDL reduction (RR 0·90, 95% CI 0·87-0·93; p&lt;0·0001),". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: All-cause mortality per 1.0 mmol/L.
  8. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, FINDINGS, sentence 6, fragment 2 of 2: "or on cancer incidence (RR 1·00, 95% CI 0·96-1·04; p=0·9), even at low LDL cholesterol concentrations.". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Cancer incidence, with no significant effect.
  9. Supports: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, INTERPRETATION, sentence 2, fragment 1 of 2: "There was no evidence of any threshold within the cholesterol range studied,". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: No evidence of a threshold within the range studied.
  10. Background: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1016/S0140-6736(10)61350-5>
     Locator: Abstract, FUNDING, sentence 1: "UK Medical Research Council, British Heart Foundation, European Community Biomed Programme, Australian National Health and Medical Research Council, and National Heart Foundation.". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c.
     How it applies: Funders named in the abstract.

## Context: Adults 40 to 75 without CVD, with a risk factor and a 10-year risk at or above 10% (USPSTF 2022 statin statement)

Recipient: Adult; Population: Adults aged between 40 and 75 with no known cardiovascular disease and no signs or symptoms of it, who have at least one cardiovascular risk factor (abnormal blood fats, diabetes, hypertension or smoking) and whose estimated chance of a cardiovascular event within ten years is 10% or more.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 40 to 75; Follow-up: Not applicable (guideline context)

### The USPSTF advises clinicians to prescribe a statin as primary prevention of cardiovascular disease to adults between 40 and 75 who have at least one cardiovascular risk factor (abnormal blood fats, diabetes, high blood pressure or smoking) and whose estimated chance of a cardiovascular event within 10 years is 10% or more. It grades this recommendation B. The abstract says the Task Force found a net benefit of at least moderate size, with moderate certainty.

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Adult; Population: Adults aged between 40 and 75 with no known cardiovascular disease and no signs or symptoms of it, who have at least one cardiovascular risk factor (abnormal blood fats, diabetes, hypertension or smoking) and whose estimated chance of a cardiovascular event within ten years is 10% or more.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 40 to 75; Follow-up: Not applicable (guideline context)
- Limitations: Primary prevention only: adults with no history of cardiovascular disease and no signs or symptoms of it. The Task Force states its own certainty level, which is not a GRADE rating, so the claim certainty stays not assessed. The advice depends on an estimated risk; the abstract does not say which risk equation to use. The B label is read from the parenthesis that follows the first recommendation sentence in the abstract. Only the PubMed abstract and the date line of the USPSTF page were read, not the full statement or its evidence review. PubMed lists no correction to the statement (checked 2026-10-15).
- Last checked: 2026-10-15
- Sources:
  1. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, sentence 1. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: Who the statement covers, and the age, risk factor and risk thresholds.
  2. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, start of sentence 2 (the grade label that follows sentence 1). Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: The grade B label.
  3. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, EVIDENCE ASSESSMENT, sentence 1. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: A net benefit of at least moderate size, with moderate certainty.
  4. Background: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, POPULATION, sentence 1. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: The statement concerns adults 40 or older without known CVD or its signs and symptoms.
  5. Background: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Page header, date line of the final recommendation statement. Retrieved 2026-10-15T13:55:01Z. Source state: Current. Snapshot hash: 4dc5ca7454ce0f81f1b10f6c3d032c470d9ca43edda448bcad12bd22994e70c4.
     How it applies: Date of the final statement.

## Context: Adults 40 to 75 without CVD, with a risk factor and a 10-year risk of 7.5% to under 10% (USPSTF 2022 statin statement)

Recipient: Adult; Population: Adults aged between 40 and 75 with no known cardiovascular disease and no signs or symptoms of it, who have at least one cardiovascular risk factor and whose estimated chance of a cardiovascular event within ten years is 7.5% to under 10%.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 40 to 75; Follow-up: Not applicable (guideline context)

### For the same group of adults between 40 and 75 with at least one cardiovascular risk factor, when the estimated 10-year chance of a cardiovascular event is 7.5% to under 10%, the USPSTF advises clinicians to offer a statin selectively for primary prevention. It grades this recommendation C and says benefit is less likely than in the group at 10% or more. The abstract says the Task Force found a net benefit that is at least small, with moderate certainty.

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Adult; Population: Adults aged between 40 and 75 with no known cardiovascular disease and no signs or symptoms of it, who have at least one cardiovascular risk factor and whose estimated chance of a cardiovascular event within ten years is 7.5% to under 10%.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 40 to 75; Follow-up: Not applicable (guideline context)
- Limitations: A C grade means a selective offer to individual patients, not a general recommendation, so this atlas keeps it as a claim and writes no recommendation record for it (the direction field has no value for selective offering). The C label is read from the parenthesis that follows this statement in the abstract. The Task Force certainty is its own rating, not GRADE. Only the PubMed abstract was read.
- Last checked: 2026-10-15
- Sources:
  1. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, sentence 2, fragment 1 (without the grade label). Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: The recommendation to selectively offer a statin.
  2. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, sentence 2, fragment 2 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: The 7.5% to under 10% risk band.
  3. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, sentence 3. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: Benefit is less likely than at 10% or more.
  4. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, start of sentence 4 (the grade label that follows sentence 3). Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: The grade C label.
  5. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, EVIDENCE ASSESSMENT, sentence 2, fragment 3 of 3. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: A net benefit that is at least small.

## Context: Adults 76 or older without CVD (USPSTF 2022 statin statement)

Recipient: Adult; Population: Adults aged 76 or older with no known cardiovascular disease and no signs or symptoms of it, who are considering starting a statin for primary prevention.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 76 or older; Follow-up: Not applicable (guideline context)

### For adults aged 76 or older, the USPSTF finds the evidence now available too limited to judge whether starting a statin for primary prevention of cardiovascular events and death does more good than harm (an I statement).

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Adult; Population: Adults aged 76 or older with no known cardiovascular disease and no signs or symptoms of it, who are considering starting a statin for primary prevention.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 76 or older; Follow-up: Not applicable (guideline context)
- Limitations: An I statement means the evidence is too thin to support a recommendation either way. It is not advice against a statin, and it says nothing about people already taking one. Only the PubMed abstract was read.
- Last checked: 2026-10-15
- Sources:
  1. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, sentence 4, fragment 1 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: Evidence insufficient to assess benefits and harms of starting a statin.
  2. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, sentence 4, fragment 2 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: Adults 76 or older.
  3. Supports: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.13044>
     Locator: Abstract, RECOMMENDATION, sentence 5. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: 26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5.
     How it applies: The I statement label.

## Guidance, authorization and access

### Recommendation `cardio:rec-uspstf-2022-statin-76-plus-i`

- Drug: Statins (`cardio:statins`)
- Direction: Evidence is insufficient to recommend for or against
- Issued by: U.S. Preventive Services Task Force (`core:uspstf`)
- Guideline record: USPSTF 2022: statin use for primary prevention of CVD in adults (`cardio:guideline-uspstf-2022-statin`)
- Guideline: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.; snapshot `cardio:pubmed-35997723-2026-10-15`
- Jurisdictions: United States; note: Issued by a United States panel; the abstract gives US disease figures.
- Strength: I statement (evidence insufficient) (USPSTF letter grade (A, B, C, D or an I statement), as the abstract labels it. The grade definitions were not read here.)
- Effective: 2022-08-23 (The date on the USPSTF page for the final statement.)
- Supersession: Not checked
- Applies to: Recipient: Adult; Population: Adults aged 76 or older with no known cardiovascular disease and no signs or symptoms of it, who are considering starting a statin for primary prevention.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 76 or older; Follow-up: Not applicable (guideline context)
- Basis: claim `cardio:claim-uspstf-2022-statin-76-plus-i`

### Recommendation `cardio:rec-uspstf-2022-statin-b`

- Drug: Statins (`cardio:statins`)
- Direction: Recommended
- Issued by: U.S. Preventive Services Task Force (`core:uspstf`)
- Guideline record: USPSTF 2022: statin use for primary prevention of CVD in adults (`cardio:guideline-uspstf-2022-statin`)
- Guideline: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement, edition Recommendation statement published in JAMA 2022;328(8):746-753. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review and the Task Force grade definitions were not read. PubMed lists no correction to the statement.; snapshot `cardio:pubmed-35997723-2026-10-15`
- Jurisdictions: United States; note: Issued by a United States panel; the abstract gives US disease figures.
- Strength: B recommendation (USPSTF letter grade (A, B, C, D or an I statement), as the abstract labels it. The grade definitions were not read here.)
- Effective: 2022-08-23 (The date on the USPSTF page for the final statement.)
- Supersession: Not checked
- Applies to: Recipient: Adult; Population: Adults aged between 40 and 75 with no known cardiovascular disease and no signs or symptoms of it, who have at least one cardiovascular risk factor (abnormal blood fats, diabetes, hypertension or smoking) and whose estimated chance of a cardiovascular event within ten years is 10% or more.; Care setting: Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 40 to 75; Follow-up: Not applicable (guideline context)
- Basis: claim `cardio:claim-uspstf-2022-statin-b`

## Connected pages

- More LDL lowering, fewer major vascular events: High LDL cholesterol (`cardio:high-ldl-cholesterol`) [a claim, not a settled fact; see claim `cardio:claim-ctt-ldl-lowering-reduces-vascular-events` and its context]
- Files under this front: Medicines (`cardio:front-medicines`)
- USPSTF 2022 (grade B): ages 40 to 75 with a risk factor and a 10-year risk of at least 10%: Preventing heart attack, stroke and heart failure (`cardio:cardiovascular-prevention`) [a claim, not a settled fact; see claim `cardio:claim-uspstf-2022-statin-b` and its context]
- Related to: MedlinePlus (`core:medlineplus`)
- Related to: Ezetimibe (`cardio:ezetimibe`)
- Related to: Cardiovascular polypill (`cardio:polypill`)

## Provenance

Content hash: 10cdb1bf3d24848df1a4e30f0e2cdf5465c6de37f3fa8e2a16b6449c9afd3f13
Last substantive edit: 2026-10-15
Evidence last checked: 2026-10-14