Preventing cardiovascular disease in New Zealand: making better use of statins but also tobacco control, changing the food supply and other strategies.

There is new evidence from a very large systematic review and meta-analysis (Navarese et al 2018), that using statins for reducing levels of low-density lipoprotein cholesterol reduces the risk of premature death. In this viewpoint article we consider the implications of this new evidence for New Zealand but also examine how the use of statins may be improved for primary prevention of cardiovascular disease (CVD) in this country. We suggest the need to explore such options as fixed-dose combination pills containing statins, three-drug polypills, behind-the-counter dispensing and six-month prescriptions. But in addition to pharmacological prevention of CVD, there is a need for improved population-wide changes to the environment. These include adopting policies to improve tobacco control, the nutrition environment (eg, particularly around sodium), alcohol control and making walking and cycling easier options.