University of Oulu

Strandberg, T. E. (2022). Benefits and limitations of statin use in primary cardiovascular prevention: Recent advances. Polish Archives of Internal Medicine, 132(5).

Benefits and limitations of statin use in primary cardiovascular prevention : recent advances

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Author: Strandberg, Timo E.1,2
Organizations: 1University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
2University of Oulu, Center for Life Course Health Research, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Medycyna Praktyczna, 2022
Publish Date: 2022-11-25


The status of low-density lipoprotein (LDL) cholesterol is strong as an essential cause of atherosclerotic vascular disease (ASCVD) and primary target of lipid lowering. Drugs affecting primarily LDL cholesterol through an increase of LDL receptor expression are the backbone of current therapy, and generic statins are generally safe, effective, and inexpensive drugs serving this purpose. Statins are indicated for practically all patients in secondary prevention, whereas treatment in primary prevention (healthy individuals) is based on a calculated 10-year risk of ASCVD. At “borderline” (from 5% to <⁠7.5%) and “intermediate” (from 7.5% to <⁠20%) risk various biomarkers (eg, coronary artery calcium) are available for accurate assessment of the individual risk. The calculation of a lifetime risk instead of the 10-year risk can be especially useful in younger people. More information about the benefits and risks of statins in primary prevention in older people (>70 years of age) will be provided by ongoing randomized and controlled trials (STAREE and PREVENTABLE). In this narrative review, I shall present recent advances in the use of statins in younger and older healthy people, and discuss their benefits and potential risks. I also raise a question whether with the current evidence base, most people in affluent societies would benefit from taking statins.

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Series: Polskie archiwum medycyny wewnetrznej
ISSN: 0032-3772
ISSN-E: 1897-9483
ISSN-L: 0032-3772
Volume: 132
Issue: 5
Article number: 16258
DOI: 10.20452/pamw.16258
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: The paper was financed by the Helsinki University Hospital (VTR funding, TYH2022103).
Copyright information: This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY‑NC‑SA 4.0), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited, distributed under the same license, and used for noncommercial purposes only. For commercial use, please contact the journal office at