The role of HMG-CoA reductase inhibitors in primary prevention of cardiovascular disease: benefit-risk ratio
Izmozherova N.V., Kostash V.A., Shambatov M.A., Popov A.A.
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.
For citations: Izmozherova N.V., Kostash V.A., Shambatov M.A., Popov A.A. The role of HMG-CoA reductase inhibitors in primary prevention of cardiovascular disease: benefit-risk ratio. Pharmateca. 2025;32(8):128-135. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.8.128-135
Authors’ contribution: The concept and design of the study, writing of the text – Izmozherova N.V., Kostash V.A. Collection and processing of the material – Kostash V.A., Shambatov M.A. Editing – Izmozherova N.V., Popov A.A. Approval of the final version of the article – all authors.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Keywords
HMG-CoA reductase inhibitors
primary prevention
dyslipidemia
geriatrics
side effects
clinical guidelines
SCORE2
MACE
About the Authors
Nadezhda V. Izmozherova, Dr. Sci. (Med.), Professor, Ural State Medical University, Yekaterinburg, Russia; nadezhda_izm@mail.ru, ORCID: https://orcid.org/0000-0001-7826-9657 (corresponding author)V.A. Kostash, Ural State Medical University, Yekaterinburg, Russia; ORCID: https://orcid.org/0009-0004-8918-4279
M.A. Shambatov, Ural State Medical University, Yekaterinburg, Russia; ORCID: https://orcid.org/0000-0001-7312-415X
A.A. Popov, Ural State Medical University, Yekaterinburg, Russia; ORCID: https://orcid.org/0000-0001-6216-2468
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