For a discussion on using statins for primary prevention of cardiac events: http://www.sciencebasedmedicine.org/...chrane-review/

My read of this evidence is that there is solid evidence that statins have a real benefit for primary prevention. This benefit is small, which is exactly what I would predict for a preventive measure in a low-risk population. The data also show that statins are safe. The major risk is for the development of an inflammatory muscle disease, but that is very rare. For interventions that prevent death – that lower mortality – I think even small benefits are worthwhile. Further, having a heart attack or stroke, even if it is not a fatal event, has a very negative effect on quality of life. Taken together, one person per year out of several hundred taking statins for primary prevention will avoid a heart attack, stroke, or death. From a purely medical point of view, that sound pretty good to me.

What seems reasonable is to use statins for primary prevention in those who have some risk factors for vascular disease, in patients with genetically high cholesterol, and in those with high cholesterol or significant risk factors in whom lifestyle counseling has not yielded adequate results. Try diet and exercise first – and always in conjunction with medication, but statins are a reasonable choice in selected patients, even for primary prevention. We could use more studies to better delineate where to draw that line, but that will be difficult as any difference in outcome is likely to be slight and therefore massive trials will be needed to get statistically significant results.