Stephen P Adams, Nima Alaeiilkhchi, Sara Tasnim, James M Wright

Key messages

• Pravastatin decreases low‐density lipoprotein cholesterol and the effect is dependent on the dose over the range of 5 mg to 160 mg.
• Pravastatin at 80 mg/day is the maximal licensed dose.
• From other systematic reviews we conducted, pravastatin has a similar effect on cholesterol to fluvastatin and has a lesser effect on cholesterol than the other statins.

What are cholesterol and blood fats?

Cholesterol is required to build and maintain all animal cell membranes and is critical to human life. Main components of cholesterol are low‐density lipoprotein, high‐density lipoprotein, and triglycerides. Low‐density lipoprotein transports fat molecules around the body in the blood and delivers fat molecules to cells. High‐density lipoprotein removes fat molecules from cells and transports it to the liver. Cholesterol and its components low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol can be measured in the blood. Triglycerides are found in all lipoproteins and can also be measured in the blood. Blood fats are thought to be related to adverse events affecting the heart and blood vessels.

What is pravastatin?

Pravastatin is one of a class of medication called statins that lower blood cholesterol. What are other statins? Do they have any unwanted effects?

What did we want to find out?

How do different doses of pravastatin affect fats in our blood?

What did we do?

We searched for studies that compared pravastatin with a non‐active form of treatment (placebo) over a three to 12‐week duration and measured cholesterol and other fats in the blood. We assessed unwanted effects by looking at how many people left the studies because of unwanted effects. We considered people of any age, with and without evidence of cardiovascular disease.

What did we find?

We found 64 trials that studied the effects of different doses of pravastatin in 9771 participants. People taking 5 mg to 160 mg of pravastatin per day lowered their low‐density lipoprotein cholesterol by 18.3% to 35.3%. The difference in unwanted effects between pravastatin and placebo was uncertain in these short‐term studies.

What are the main limitations of the evidence?

Many studies did not report unwanted effects nor the number of people who left the studies because of unwanted effects.

How up to date is this evidence?

The evidence is up to date to September 2021.