In this study, we make the case that, unlike secondary prevention, primary prevention using statins for cardiovascular risk reduction is much more complicated due to the requirement in many cases to rely on a risk algorithm, the panoply of algorithms, the changes that occur in them and the fact that many clinicians forego formal calculation. We sought to describe in more simple, teachable and universally applicable terms what the ‘statin-eligible primary prevention patient’ might be considered if we used the eligibility criteria of successful, randomized primary prevention trials of statins and the general characteristics of the enrollees of these trials. We show through creation of case scenarios that would meet RCT eligibility criteria that the risk algorithms almost invariably result in a risk too low to meet guideline sanctioned statin therapy for primary prevention. By synthesizing both the eligibility criteria of the main primary prevention RCTs and the characteristics of actual enrollees, we developed a more simple definition that requires no app or risk calculation. Most of the early trials enrolled patient with high LDL-C. The trials that studied lower levels of LDL-C, such as JUPITER and HOPE-3, enrolled older patients with additional risk factors. Thus, we conclude that a practical definition emerging from the RCTs is that a statin-eligible primary prevention patient is a subject 40–70 years old with LDL-C ≥ 3.0 mmol/L or 55–80 years old with LDL-C ≥ 1.8 mmol/L and with additional risk factors. We believe this simple definition could be implemented universally, would be easy to teach and retain and would enhance knowledge translation of the RCTs proving the value of statins for primary prevention. This is a controversial but important topic for the international community to consider.

Aims To investigate how physical activity (PA) volume, intensity, duration, and fragmentation are associated with the risk of all-cause and cardiovascular disease mortality. To produce centile curves for PA volume and intensity representative of US adults. Methods and results This study is based on ...

The global prevalence of obesity has more than doubled over the past four decades, currently affecting more than a billion individuals. Beyond its recognition as a high-risk condition that is causally linked to many chronic illnesses, obesity has been declared a disease per se that results in ...

Aims Sodium–glucose cotransporter-2 inhibitors (SGLT2i) are recognized for their cardiovascular benefits. This systematic review and meta-analysis evaluated the impact of SGLT2i on heart failure (HF) outcomes in cancer patients and survivors, focusing on HF hospitalization and new HF diagnoses. ...

Aims Data on self-selected modes of delivery of cardiac rehabilitation (CR) are limited. This study compared centre-based CR (cbCR) with hybrid cardiac telerehabilitation (hCTR) in terms of patient characteristics, change in physical and mental functioning, and achievement of guideline-directed ...