{
  "release_id": "5dcd9b263fe17744",
  "id": "cardio:statins",
  "owner": "cardio",
  "kind": "drug",
  "slug": "statins",
  "name": "Statins",
  "aliases": [
    "HMG-CoA reductase inhibitors"
  ],
  "atlases": [
    "cardio"
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  "summary_plain": "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.",
  "summary_technical": "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.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-14",
  "next_review_due": null,
  "identifiers": [
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      "match": "exact",
      "version": "MeSH linked-data descriptor record fetched on 2026-10-14, lastUpdated 2020-05-27; the record states no yearly MeSH release",
      "label": null,
      "from_source": false
    }
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  "navigation": {
    "cardio": {
      "condition-area": [
        "coronary-and-vascular-disease",
        "risk-and-prevention"
      ]
    }
  },
  "payload": {
    "level": "class",
    "mechanism": "Slow down how much cholesterol the liver makes, and increase the liver's ability to remove LDL cholesterol already in the blood (MedlinePlus)."
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  "content_digest": "10cdb1bf3d24848df1a4e30f0e2cdf5465c6de37f3fa8e2a16b6449c9afd3f13",
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      "owner": "cardio",
      "subject_entity_id": "cardio:statins",
      "category": "recommendation",
      "statement": "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.",
      "context": {
        "id": "cardio:ctx-ada-kdigo-2022-diabetes-and-ckd",
        "label": "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_note": "Adults, as the report's introduction puts it (adults with diabetes and CKD); the report gives no age bounds",
        "life_stage_terms": null,
        "gestational_age_min_days": null,
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        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Not applicable (guidance context)",
        "eligibility": {
          "inclusion": [
            "Type 1 or type 2 diabetes",
            "Chronic kidney disease as the report defines it"
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          "exclusion": []
        }
      },
      "evidence_stage": "guidance",
      "certainty": "not_assessed",
      "certainty_method": null,
      "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).",
      "editorial_state": "draft",
      "checked_at": "2026-10-15",
      "next_review_due": null,
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      "citations": [
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      "id": "cardio:claim-ctt-ldl-lowering-reduces-vascular-events",
      "owner": "cardio",
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      "category": "effect",
      "statement": "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.",
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        "label": "Participants of large randomised statin trials in the Cholesterol Treatment Trialists individual-participant meta-analysis (2010)",
        "recipient": "unknown",
        "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)",
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        "followup_description": "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.",
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          "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\"",
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