XXXX and primary cardiovascular prevention. Uncertain balance between benefits and risks.

@entity1 @entity64 @entity583 @entity548 @entity101 @entity6 @entity117 @entity1779 @entity715 @entity65
Most individuals with no pre-existing @entity65 have a low risk of experiencing arterial @entity715 . Using the standard Prescrire methodology, we reviewed the literature on the risk-benefit balance of @entity117 in the primary prevention of cardiovascular events. In the general population, a meta-analysis in 95 456 @entity1 suggests that @entity117 has no effect on either total or cardiovascular mortality. @entity117 may slightly reduce the risk of @entity64 in @entity1 and @entity583 in @entity1 , but it increases the risk of @entity548 . It is unclear whether the benefits outweigh the risks. @entity117 does not reduce mortality in the elderly. in one trial, @entity117 reduced the risk of @entity64 and @entity583 in @entity1 aged 65 and over. However, the risk of @entity1779 associated with @entity117 increases with age. Therefore, the risk-benefit balance of @entity117 in primary cardiovascular prevention in the elderly is uncertain. @entity117 is more beneficial in @entity1 with cardiovascular risk factors, but the @entity548 risk is sometimes higher too. In clinical trials, @entity117 did not reduce either total or cardiovascular mortality in @entity101 or @entity6 @entity1 . In contrast, it reduced the risk of @entity583 in @entity101 @entity1 and @entity6 @entity1 . @entity117 did not prevent cardiovascular events in smokers, and has not been assessed in @entity1 with hypercholesterolaemia. In practice, the risks outweigh the benefits when @entity117 is used to prevent a first thrombotic event in @entity1 at low risk. When the cardiovascular risk is higher than in the general population, for example in @entity1 with risk factors, the weak preventive effects of @entity117 on @entity583 and @entity64 may outweigh the small extra risk of @entity548 . The possible value of @entity117 for cardiovascular prevention should be discussed with each individual @entity1 . In general, it is preferable to recommend measures with a proven impact on mortality, such as dietary changes, smoking cessation, or drug therapy for @entity1 with risk factors.
