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Therapeutics
Cholesterol lowering with simvastatin reduced stroke in patients with, or at risk of, vascular disease

https://doi.org/10.1136/ebm.9.5.143

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    Collins R, Armitage J, Parish S, et al. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20 536 people with cerebrovascular disease or other high-risk conditions. Lancet 2004;363:757–67.
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 Q Does cholesterol lowering with simvastatin reduce the incidence of stroke in patients with, or at high risk of, vascular disease?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★★☆ Neurology ★★★★★★☆ Geriatrics ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial (Heart Protection Study).

    Embedded ImageAllocation:

    {concealed*}†.

    Embedded ImageBlinding:

    blinded {patients, clinicians, and data monitoring committee}†.*

    Embedded ImageFollow up period:

    5 years.

    Embedded ImageSetting:

    {69 hospitals in the UK}†.

    Embedded ImagePatients:

    20 536 patients (mean age 64 y, 75% men) who had non-fasting total cholesterol concentrations ⩾3.5 mmol/l (135 mg/dl) and a medical history of cerebrovascular disease, coronary disease, other occlusive arterial disease, or diabetes, or were men ⩾65 years of age treated for hypertension. Exclusion criteria: clear indication …

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