Should we treat all primary prevention patients with statins?

3-Hydroxy-3-methylglutary coenzyme A (HMG-CoA) reductase inhibitors have been shown to reduce cardiac events in different high-risk and medium-risk patient groups. Although there are other medications to lower cholesterol, evidence that these agents will provide protection from initial cardiac events is limited or does not exist. Also, although many physicians advocate combining second agents with statins to improve certain lipid fractions, evidence of improved reduction of initial cardiac events from these combinations is also lacking. Therefore, aggressive use of HMG-CoA reductase inhibitors remains the proven treatment to treat lipid abnormalities in primary patients.