Dyslipidemia, primary CV prevention
Lipid metabolism disorder in patients without established atherosclerotic cardiovascular disease. Treatment is guided by risk stratification.
ICD-10 E78.54 drugs
Also known as: Hyperlipidemia primary prevention
Drugs used for this condition
- AAtorvastatinFirst line · HMG-CoA reductase inhibitors (statins)In adults without established CVD, statin therapy is guided by risk stratification. USPSTF 2022 recommends statins in adults 40–75 with at least one CV risk factor and a 10-year ASCVD risk of 10 % or more. ESC/EAS 2019 uses SCORE2 and titrates aggressiveness by risk category.
- ARosuvastatinFirst line · HMG-CoA reductase inhibitors (statins)Prescribed according to cardiovascular risk stratification, same as atorvastatin. Rosuvastatin's advantage is greater LDL reduction at lower doses: 5–10 mg of rosuvastatin is equivalent to 20–40 mg of atorvastatin. Convenient when potent lipid lowering is needed at a minimal dose.
- ASimvastatinFirst line · HMG-CoA reductase inhibitors (statins)Prescribed for primary prevention in patients with elevated cardiovascular risk. Dose 20–40 mg in the evening. The 80 mg dose is no longer recommended – FDA restricted it in 2011 due to increased myopathy and rhabdomyolysis risk. New patients do not start at 80 mg; it is retained only for those who have taken it for over 12 months without adverse effects.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit