{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:32:30Z","timestamp":1789997550681,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,21]],"date-time":"2014-01-21T00:00:00Z","timestamp":1390262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2014,2]]},"abstract":"\n Objectives<\/jats:title>\n \n To assess the effect of preventive pravastatin treatment on coronary heart disease (\n CHD<\/jats:styled-content>\n ) morbidity and mortality in older persons at risk for cardiovascular disease (\n CVD<\/jats:styled-content>\n ), stratified according to plasma levels of homocysteine.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \n A post hoc subanalysis in the\n PRO<\/jats:styled-content>\n spective\n S<\/jats:styled-content>\n tudy of\n P<\/jats:styled-content>\n ravastatin in the\n E<\/jats:styled-content>\n lderly at\n R<\/jats:styled-content>\n isk (\n PROSPER<\/jats:styled-content>\n ), started in 1997, which is a double\u2010blind, randomized, placebo\u2010controlled trial with a mean follow\u2010up of 3.2\u00a0years.\n <\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n \n Primary care setting in two of the three\n PROSPER<\/jats:styled-content>\n study sites (\n N<\/jats:styled-content>\n etherlands and\n S<\/jats:styled-content>\n cotland).\n <\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n Individuals (n\u00a0=\u00a03,522, aged 70\u201382, 1,765 male) with a history of or risk factors for\n CVD<\/jats:styled-content>\n were ranked in three groups depending on baseline homocysteine level, sex, and study site.\n <\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Pravastatin (40\u00a0mg) versus placebo.<\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n \n Fatal and nonfatal\n CHD<\/jats:styled-content>\n and mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the placebo group, participants with a high homocysteine level (n\u00a0=\u00a0588) had a 1.8 higher risk (95% confidence interval (\n CI<\/jats:styled-content>\n )\u00a0=\u00a01.2\u20132.5,\n P<\/jats:italic>\n \u00a0=\u00a0.001) of fatal and nonfatal\n CHD<\/jats:styled-content>\n than those with a low homocysteine level (n\u00a0=\u00a0597). The absolute risk reduction in fatal and nonfatal\n CHD<\/jats:styled-content>\n with pravastatin treatment was 1.6% (95%\n CI<\/jats:styled-content>\n \u00a0=\u00a0\u22121.6 to 4.7%) in the low homocysteine group and 6.7% (95%\n CI<\/jats:styled-content>\n \u00a0=\u00a02.7\u201310.7%) in the high homocysteine group (difference 5.2%, 95%\n CI<\/jats:styled-content>\n \u00a0=\u00a00.11\u201310.3,\n P<\/jats:italic>\n \u00a0=\u00a0.046). Therefore, the number needed to treat (\n NNT<\/jats:styled-content>\n ) with pravastatin for 3.2\u00a0years for benefit related to fatal and nonfatal\n CHD<\/jats:styled-content>\n events was 14.8 (95%\n CI<\/jats:styled-content>\n \u00a0=\u00a09.3\u201336.6) for high homocysteine and 64.5 (95%\n CI<\/jats:styled-content>\n \u00a0=\u00a021.4\u2013\u221e) for low homocysteine.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n In older persons at risk of\n CVD<\/jats:styled-content>\n , those with high homocysteine are at highest risk for fatal and nonfatal\n CHD<\/jats:styled-content>\n . With pravastatin treatment, this group has the highest absolute risk reduction and the lowest\n NNT<\/jats:styled-content>\n to prevent fatal and nonfatal\n CHD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.12660","type":"journal-article","created":{"date-parts":[[2014,1,21]],"date-time":"2014-01-21T15:20:27Z","timestamp":1390317627000},"page":"213-221","source":"Crossref","is-referenced-by-count":22,"title":["Homocysteine Levels and Treatment Effect in the Prospective Study of Pravastatin in the Elderly at Risk"],"prefix":"10.1111","volume":"62","author":[{"given":"Yvonne M.","family":"Drewes","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalinde K. E.","family":"Poortvliet","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanet W.","family":"Blom","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"de Ruijter","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudi G. 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