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Cardiovascular disease (CVD), which comprises heart attacks (myocardial infarction), angina, and strokes, is the principal cause of death in the world and is a major cause of morbidity worldwide. High blood cholesterol is linked to CVD events and is an important risk factor. Therefore, decreasing high blood cholesterol is an important way to reduce the chances of suffering a CVD event. Blood cholesterol may come from foods that are high in fat, and is also produced by some of our body’s organs (most of this production is at night (between 12:00 am and 6:00 am).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 26, 2016

Dementia (including Alzheimer's disease) is a global healthcare concern; the number of people affected worldwide is predicted to double every 20 years, reaching 74.7 million in 2010 and 131.5 million in 2050. Therefore, it is important to find means of preventing dementia. It has been suggested that high levels of cholesterol in the serum (part of the blood) may increase the risk of dementia and that treatment with cholesterol‐lowering medicines such as statins may reduce the risk of dementia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 4, 2016

This review evaluated the effect of pravastatin therapy on cancer risk, according to age. The authors concluded that pravastatin may be associated with an increased risk of cancer among elderly people, but further verification was needed. The conclusions should be regarded with some caution because of limitations in the review process.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

This review assessed the relative efficacy of pravastatin, simvastatin and atorvastatin. The authors concluded that the evidence suggests there is no statistically significant difference in long-term cardiovascular outcomes between standard doses of these statins. Statements on relative efficacy were based on indirect comparisons, thus the authors' cautious conclusion appears appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

A mini-review (Griffiths, 2002) of double-blind randomized controlled trials (RCTs) was undertaken to assess the long-term effect of lipid lowering treatments (statins versus placebo) in secondary prevention of myocardial infarction (MI). The population sample was adult patients with a history of MI, documented coronary heart disease or coronary artery disease. The Cochrane Library and the database Medline were searched and three RCTs appeared to possess all of the stipulated inclusion and exclusion criteria. The trials all compared statins against a placebo; one trial was of simvastatin--the Scandinavian Simvastatin Survival Study (1994)--and the other two were of pravastatin--the Cholesterol and Recurrent Events Trial (CARE) (Sacks et al, 1996) and Long Term Intervention with Pravastatin Ischaemic Disease (LIPID) (Anon, 1998). The trials demonstrated that statins had a clear and consistent effect in significantly reducing the risk of MI. Overall an approximate decline of 30% in MI was produced from the three trials.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

BACKGROUND: Elevation of adiponectin levels is a potential therapeutic tool against cardiovascular and metabolic diseases. Clinical evidence suggests differences between fibrates and statins in improving circulating concentrations of adiponectin.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

This meta-analysis was conducted to evaluate the effect of statins on the lipid profile in pediatric and adolescent patients with familial hypercholesterolemia (FH). Randomized, double-blind, controlled trials comparing statins with placebo were identified through electronic and manual search; percent reductions from baseline were calculated for various lipid parameters. Standardized mean differences (effect size) with 95% confidence interval (CI) were calculated for each study and pooled effect size was calculated. A total of 6 studies were included in the meta-analysis. As compared to placebo, statins caused a significant decrease in total cholesterol (TC) [-3.11% (95% CI -3.46 to -2.99)], low-density lipoprotein (LDL) [-4.01% (95% CI -4.27 to -3.81)], triglyceride (TG) [-1.41 (95% CI -1.66 to -1.26)] and a significant increase in high-density lipoprotein (HDL) [1.12 (95% CI 0.73 1.13)]. In conclusion, statins were shown to have good efficacy for the treatment of FH in children.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

OBJECTIVE: To determine the impact of statin therapy on the combined endpoint of cardiovascular events in women and men separately.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

How do statins and combination drugs compare in lowering "bad" cholesterol (LDL-c)?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: November 1, 2010

In the United States, coronary heart disease and cardiovascular disease account for nearly 40% of all deaths each year. Coronary heart disease continues to be the leading cause of mortality and a significant cause of morbidity among North Americans. In 2006, coronary heart disease claimed 607 000 lives, translating into about 1 out of every 5 deaths in the United States. High levels of cholesterol, or hypercholesterolemia, are an important risk factor for coronary heart disease. The 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors, also known as statins, are the most effective class of drugs for lowering serum low-density lipoprotein cholesterol concentrations. They are first-line agents for patients who require drug therapy to reduce serum low-density lipoprotein cholesterol concentrations. The purpose of this review is to compare the benefits and harms of different statins in adults and children with hypercholesterolemia.

Drug Class Reviews - Oregon Health & Science University.

Version: November 2009

The authors concluded that statins did not produce a class effect in terms of insulin sensitivity in non-diabetic patients and there were differences in effect between individual statins. Although there was a possibility of publication bias, this was a largely well-conducted review and the authors' conclusions seem likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

This review assessed the effects of statins used in people at risk of cardiovascular events. Statins were found to reduce cardiovascular events overall and in subgroups, but the risk of non-cardiovascular death remained unchanged. Although the evidence presented appears to support the author's conclusions, the methods of the review were not described so the reliability of the findings could not be assessed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

This review assessed the effectiveness of lipid-lowering therapies in reducing the incidence of stroke. The authors concluded that such treatments do reduce stroke incidence in patients with a history of heart disease. This review involved a large number of patients and the conclusions are likely to be broadly accurate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

The authors concluded that higher intensity statin therapy significantly increases the incidence of transaminase and creatine kinase elevations. Higher intensity hydrophilic statins appear more likely to be associated with increases in transaminase, whereas higher intensity lipophilic statins appear more likely to be associated with increases in creatine kinase. Overall, the review was well-conducted and these conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Both the US Preventive Services Task Force (USPSTF) and the National Cholesterol Education Program (NCEP ATP III) have issued recommendations on screening for dyslipidemia in adults. To guide the USPSTF in updating its 2001 recommendations, we reviewed evidence relevant to discrepancies between these recommendations.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: June 2008

The study found that regular lipid monitoring in individuals with and without cardiovascular disease is likely to be beneficial to both patients and to the health service, and frequent monitoring strategies appear to be cost-effective.

Health Technology Assessment - NIHR Journals Library.

Version: December 2015

This guideline has been developed to advise on supporting people with dementia and their carers in health and social care. The guideline recommendations have been developed by a multidisciplinary team of health and social care professionals, a person with dementia, carers and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to practitioners and service commissioners in providing and planning high-quality care for those with dementia while also emphasising the importance of the experience of care for people with dementia and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2007

The study found that for induction therapy in adult renal transplantation no treatment regimen appeared more effective than another in reducing graft loss or mortality, and, for maintenance therapy, none of the treatment regimens was better for all outcomes or appeared most effective at reducing graft loss. When comparing all treatment regimens only one combination of treatments was cost-effective.

Health Technology Assessment - NIHR Journals Library.

Version: August 2016

The study found that tacrolimus maintenance therapy (with azathioprine) and basiliximab induction (with tacrolimus and azathioprine maintenance therapy) were likely to be cost-effective therapies for children and adolescents undergoing renal transplantation. When all immunosuppressive regimens were simultaneously compared using extrapolated adult data, only basiliximab induction therapy with tacrolimus and azathioprine maintenance therapy was cost-effective.

Health Technology Assessment - NIHR Journals Library.

Version: August 2016

Dyslipidemias, disorders of lipid metabolism, are important risk factors for coronary heart disease (CHD). Identification of children with dyslipidemias could lead to interventions aimed at decreasing their risk of CHD as adults.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: July 2007

Systematic Reviews in PubMed

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