Statin Use for the Primary Prevention of Cardiovascular Disease (CVD) in Adults: Preventive Medication

1. Improving the accuracy of CVD risk prediction in all racial and ethnic and socioeconomic groups.
2. The balance of benefits and harms of initiating statin use for the primary prevention of cardiovascular events in adults 76 years or older.
3. The efficacy and safety of long-term statin use in adults younger than 40 years, and to determine the effects of earlier vs delayed initiation of statin use, particularly in persons with an estimated high long-term (longer than 10 years [e.g., lifetime]) risk of CVD.
4. The causes of disparities in statin use and effective methods to reduce disparities.
5. Trials that directly compare statin therapy titrated to target lipid levels vs fixed-dose therapy to inform optimal dosing strategies. Trials that directly compare higher- vs lower-intensity statin therapy and are powered to assess clinical outcomes are also needed.
6. Definitively determining whether statin therapy is associated with increased risk of diabetes in primary prevention populations.
7. The role of patient preferences in decisions to prescribe statins for persons across the spectrum of CVD risk.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of initiating a statin for the primary prevention of CVD events and mortality in adults 76 years or older.

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