Starting a statin when 10-year cardiovascular risk is 7.5% to under 10%

For this risk band the Task Force concludes with moderate certainty that statin use has at least a small net benefit for preventing cardiovascular events and all-cause mortality.

Applies to: Adults aged 40 to 75 with a 10-year risk of 7.5% to less than 10% and at least one risk factor.

Across 22 trials, statins were associated with lower all-cause mortality (absolute risk difference -0.35%), fewer myocardial infarctions (-0.85%), fewer strokes (-0.39%), and fewer composite cardiovascular events (-1.28%).

Applies to: Adults without prior cardiovascular events across a range of baseline risk, followed for 6 months to 6 years. These figures are not specific to the 7.5% to under 10% band.

The association with cardiovascular mortality was not statistically significant.

Applies to: Same pooled trial population.

Statin therapy was not significantly associated with increased serious adverse events, muscle pain, or raised liver enzymes.

Applies to: 22 randomized trials plus 3 observational studies reporting harms.

Statin therapy was not significantly associated with increased diabetes risk overall, though one trial found high-intensity statin therapy was.

Applies to: Pooled trials; the high-intensity finding comes from a single trial.

The small net benefit the Task Force concludes statin use has for this risk band is forgone.

Applies to: Adults in the 7.5% to under 10% risk band.

For this band the Task Force recommends selectively offering a statin rather than prescribing one for everyone who qualifies.

Applies to: Adults in the 7.5% to under 10% risk band.