The role of HMG-CoA reductase inhibitors in primary prevention of cardiovascular disease: benefit-risk ratio

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Abstract

This systematic review examines the role of statins in the primary prevention of cardiovascular disease (CVD). Current international guidelines and the evidence base demonstrating the effectiveness of this therapy in reducing the risk of major adverse cardiovascular events (MACE) are analyzed. Particular attention is paid to controversial issues, including the use of statins in patients with intermediate risk and in individuals over 75 years of age, where the benefit-risk ratio requires a strictly individualized approach. The favorable safety profile of statins is emphasized, with many subjective side effects associated with the nocebo phenomenon, while the most significant risks include a dose-dependent increase in the incidence of type 2 diabetes mellitus and hepatotoxicity. The results of the ongoing large-scale STAREE and PREVENTABLE trials are expected to help define optimal treatment criteria, particularly in geriatric practice.

About the authors

Nadezhda V. Izmozherova

Ural State Medical University

Author for correspondence.
Email: nadezhda_izm@mail.ru
ORCID iD: 0000-0001-7826-9657

Dr. Sci. (Med.), Professor

Russian Federation, Yekaterinburg

V. A. Kostash

Ural State Medical University

Email: nadezhda_izm@mail.ru
ORCID iD: 0009-0004-8918-4279
Russian Federation, Yekaterinburg

M. A. Shambatov

Ural State Medical University

Email: nadezhda_izm@mail.ru
ORCID iD: 0000-0001-7312-415X
Russian Federation, Yekaterinburg

A. A. Popov

Ural State Medical University

Email: nadezhda_izm@mail.ru
ORCID iD: 0000-0001-6216-2468
Russian Federation, Yekaterinburg

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