APPLICATION OF THE RESULTS OF MEGATRIALS OF PRIMARY PREVENTION WITH STATINES IN CLINICAL-PRACTICE

The results of different mete-analyses conducted in primary prevention have shown an insignificant difference in total mortality or coronary heart disease (CHD) mortality; and only two studies have shown differ ences in the incidence of CHD. The WOS study, the first study in prima ry prevention done with statines, observed a 20% reduction in the tota l cholesterol, a relative risk reduction of 31%, an absolute risk redu ction of 2.4% and the number of patients who needed to be treated, to prevent coronary disease during a five year period, was 42. Subgroup a nalyses showed a greater benefit for high risk patients: smokers and t hose with peripheral vascular disease. This is why the utilization of a cardiovascular risk estimation, instead of isolated cholesterol leve ls or other risk factors, is currently recommended. However, it is imp ortant to bear in mind that the results of the WOS study cannot be eas ily extrapolated to Spain because the rates of CHD are much lower here than the ones observed in Scotland. Promotion of treatment of high ri sk patients with statines must be accompanied by a promotion of a heal thy lifestyle at both the individual and the community level.