Cardiovascular Atlas
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Statins

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.

Also called HMG-CoA reductase inhibitors

  • Drug
  • In this atlas

Overview

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.

About this drug

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).

Claims and evidence

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)
Eligibility: 5 inclusion criteria; 1 exclusion criterion
Included
  • Aged between 40 and 75
  • At least one cardiovascular risk factor: abnormal blood fats, diabetes, hypertension or smoking
  • Estimated chance of a cardiovascular event within ten years of 10% or more
  • No history of known cardiovascular disease
  • No signs or symptoms of cardiovascular disease
Excluded
  • People with known cardiovascular disease, or with its signs or symptoms

  • Recommendation Guidance Certainty not assessed

    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.

    Applies to Adult
    • 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.
    • Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.
    • United States (a USPSTF recommendation; the abstract gives US disease figures)
    • Adults aged 40 to 75
    Follow-up Not applicable (guideline context)
    Certainty method
    Not assessed
    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
    Next evidence check due
    Not scheduled
    Sources and citations (5)

    1. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, sentence 1
      How it applies
      Who the statement covers, and the age, risk factor and risk thresholds.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    2. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, start of sentence 2 (the grade label that follows sentence 1)
      How it applies
      The grade B label.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    3. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, EVIDENCE ASSESSMENT, sentence 1
      How it applies
      A net benefit of at least moderate size, with moderate certainty.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    4. Background Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, POPULATION, sentence 1
      How it applies
      The statement concerns adults 40 or older without known CVD or its signs and symptoms.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    5. Background Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Page header, date line of the final recommendation statement
      How it applies
      Date of the final statement.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      4dc5ca7454ce0f81f1b10f6c3d032c470d9ca43edda448bcad12bd22994e70c4
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

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)
Eligibility: 5 inclusion criteria; 1 exclusion criterion
Included
  • Aged between 40 and 75
  • At least one cardiovascular risk factor: abnormal blood fats, diabetes, hypertension or smoking
  • Estimated chance of a cardiovascular event within ten years of 7.5% to under 10%
  • No history of known cardiovascular disease
  • No signs or symptoms of cardiovascular disease
Excluded
  • People with known cardiovascular disease, or with its signs or symptoms

  • Recommendation Guidance Certainty not assessed

    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.

    Applies to Adult
    • 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%.
    • Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.
    • United States (a USPSTF recommendation; the abstract gives US disease figures)
    • Adults aged 40 to 75
    Follow-up Not applicable (guideline context)
    Certainty method
    Not assessed
    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
    Next evidence check due
    Not scheduled
    Sources and citations (5)

    1. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, sentence 2, fragment 1 (without the grade label)
      How it applies
      The recommendation to selectively offer a statin.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    2. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, sentence 2, fragment 2 of 2
      How it applies
      The 7.5% to under 10% risk band.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    3. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, sentence 3
      How it applies
      Benefit is less likely than at 10% or more.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    4. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, start of sentence 4 (the grade label that follows sentence 3)
      How it applies
      The grade C label.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    5. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, EVIDENCE ASSESSMENT, sentence 2, fragment 3 of 3
      How it applies
      A net benefit that is at least small.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

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)
Eligibility: 3 inclusion criteria; 1 exclusion criterion
Included
  • Aged 76 or older
  • No history of known cardiovascular disease
  • No signs or symptoms of cardiovascular disease
Excluded
  • People with known cardiovascular disease, or with its signs or symptoms

  • Recommendation Guidance Certainty not assessed

    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).

    Applies to Adult
    • 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.
    • Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.
    • United States (a USPSTF recommendation; the abstract gives US disease figures)
    • Adults aged 76 or older
    Follow-up Not applicable (guideline context)
    Certainty method
    Not assessed
    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
    Next evidence check due
    Not scheduled
    Sources and citations (3)

    1. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, sentence 4, fragment 1 of 2
      How it applies
      Evidence insufficient to assess benefits and harms of starting a statin.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    2. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, sentence 4, fragment 2 of 2
      How it applies
      Adults 76 or older.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

    3. Supports Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

      Guideline · JAMA · 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. · Published 2022-08-23 · DOI: 10.1001/jama.2022.13044 · PMID: 35997723

      Locator
      Abstract, RECOMMENDATION, sentence 5
      How it applies
      The I statement label.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      26c18d7cbf633fb4ee622238cbe61ce16a4c51fd9f00ee5831f49c33988642a5
      Reuse basis
      PubMed record fetched through NCBI E-utilities on 2026-10-15. Only the hash of the bytes is kept; nothing is committed. The USPSTF copyright notice (see source core:uspstf-about) lets the public reproduce USPSTF work only without changes, except as fair use, and asks that the USPSTF page be cited. That is not clear permission to repost wording, so public text is cite_only: public pages state the recommendation in the atlas's own words, with a citation and a link. The notice also says the work may not be sold for profit or folded into a profit-making venture without written permission from AHRQ (see source cardio:uspstf-copyright-notice, fetched 2026-10-15). Whether the atlas counts as such a venture is not settled here, so every USPSTF fact is kept in the atlas's own words. Quote rows from the abstract are short evidence fragments for the reviewer, and the USPSTF page is quoted only for its date line.

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.
Eligibility: 1 inclusion criterion; exclusion criteria not stated
Included
  • Randomised trials with at least 1000 participants and at least 2 years of treatment (abstract)
Excluded
None stated

  • Effect Evidence synthesis Certainty not assessed

    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.

    Applies to Recipient not specified
    • 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.
    • Not stated in the source (abstract only)
    • Not stated in the source (abstract only)
    • 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.
    Certainty method
    Not assessed
    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
    Next evidence check due
    Not scheduled
    Sources and citations (10)

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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"
      How it applies
      Abstract of the paper from PubMed; the full text was not read.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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;"
      How it applies
      Trial and participant counts, more versus less intensive and statin versus control.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      Locator
      Abstract, METHODS, sentence 1, fragment 3 of 3: "median follow-up 4·8 years)."
      How it applies
      Median follow-up of the statin-versus-control trials.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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."
      How it applies
      Further LDL reduction at 1 year in the more-intensive trials.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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<0·0001) further reduction in major vascular events,"
      How it applies
      Further reduction in major vascular events with more intensive regimens.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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<0·0001),"
      How it applies
      Rate ratio per 1.0 mmol/L for major vascular events.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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<0·0001),"
      How it applies
      All-cause mortality per 1.0 mmol/L.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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."
      How it applies
      Cancer incidence, with no significant effect.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      Locator
      Abstract, INTERPRETATION, sentence 2, fragment 1 of 2: "There was no evidence of any threshold within the cholesterol range studied,"
      How it applies
      No evidence of a threshold within the range studied.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    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 · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2010-11-13 · DOI: 10.1016/S0140-6736(10)61350-5 · PMID: 21067804 · PMCID: PMC2988224

      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."
      How it applies
      Funders named in the abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      dc3a4ad270917b3c28554cf4c0ecc69c74b9b6c37190764e347066b680b15b0c
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Guidance

Evidence is insufficient to recommend for or against: Statins

Applies to Adult
  • 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.
  • Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.
  • United States (a USPSTF recommendation; the abstract gives US disease figures)
  • Adults aged 76 or older
Follow-up Not applicable (guideline context)
Issued by
U.S. Preventive Services Task Force
Guideline
USPSTF 2022: statin use for primary prevention of CVD in adults; 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.
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.)
Jurisdictions
United States; note: Issued by a United States panel; the abstract gives US disease figures.
Supersession
Not checked
Basis
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).

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.

Recommended: Statins

Applies to Adult
  • 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.
  • Not stated in the abstract. The statement is addressed to clinicians who prescribe statins.
  • United States (a USPSTF recommendation; the abstract gives US disease figures)
  • Adults aged 40 to 75
Follow-up Not applicable (guideline context)
Issued by
U.S. Preventive Services Task Force
Guideline
USPSTF 2022: statin use for primary prevention of CVD in adults; 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.
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.)
Jurisdictions
United States; note: Issued by a United States panel; the abstract gives US disease figures.
Supersession
Not checked
Basis
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.

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).

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

Record details

Record id
cardio:statins
Content hash
b58d4cd4ee1df672d2de2b8c5174b31b8e697a43c24208a3a067f49090069482