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Background

Statins reduce LDL cholesterol and prevent vascular events, but their net effects in people at low risk of vascular events remain uncertain.

Methods

This meta-analysis included individual participant data from 22 trials of statin versus control (n= 134,537; mean LDL cholesterol difference 1· 08 mmol/L; median follow-up 4· 8 years) and five trials of more versus less statin (n= 39,612; difference 0· 51 mmol/L; 5· 1 years). Major vascular events were major coronary events (ie, non-fatal myocardial infarction or coronary death), strokes, or coronary revascularisations. Participants were separated into five categories of baseline 5-year major vascular event risk on control therapy (no statin or low-intensity statin)(< 5%,≥ 5% to< 10%,≥ 10% to< 20%,≥ 20% to< 30%,≥ 30%); in each, the rate ratio (RR) per 1· 0 mmol/L LDL cholesterol reduction was estimated.