Primary prevention of cardiovascular disease has been a site of medicalisation, as demonstrated by the significant increase in the use of cholesterol-lowering drugs, statins, over the last thirty years. While this is welcomed by many in the medical community, others have criticised the expansion of statin use to low-risk people. In the context of this debate, the aim of this article is to present a broad scoping review of the literature on how preventative health, risk and ‘candidacy’ for statin treatment are perceived and negotiated by clinicians and patients. We examine how evidence and knowledge about cardiovascular risk reduction is produced, interpreted and communicated and how patients’ gender, socio-demographic and cultural differences may impact patterns of statin use. We found that few studies differentiated between the use of statins in those with and those without established cardiovascular disease, despite the fact that the majority of statin users, and women in particular, fall into the primary prevention category. In this context, the process of medicalisation is predicated on healthy individuals being subject to medical surveillance of risk factors, which have acquired the status of disease in their own right. Central to this process has been the heuristic that identifies elevated cholesterol as a medical problem warranting statin treatment, as well as the difficulties encountered by doctors and patients in understanding, interpreting and communicating risk. This individualised construction of risk and disease has largely ignored the supposedly widely recognised social and political determinants of health and illness.

心血管疾病的一级预防一直是医疗化的场所，过去三十年来，降低胆固醇的药物他汀类药物的使用显着增加证明了这一点。尽管这在医学界受到许多人的欢迎，但其他人则批评他汀类药物的使用已扩展到低风险人群。在这场辩论的背景下，本文的目的是对临床医生和患者如何认识和协商他汀类药物的预防性健康，风险和“候选资格”进行广泛的文献综述。我们研究了如何产生，解释和交流有关降低心血管风险的证据和知识，以及患者的性别，社会人口统计学和文化差异如何影响他汀类药物的使用方式。我们发现，尽管大多数他汀类药物使用者（尤其是妇女）属于一级预防类别，但在有心血管疾病的人和没有心血管疾病的人之间，几乎没有研究区分他汀类药物。在这种情况下，医学化过程的前提是健康个体要接受危险因素的医学监视，而危险因素本身已经获得了疾病的地位。该过程的核心是启发式方法，该方法将胆固醇升高确定为需要他汀类药物治疗的医学问题，以及医生和患者在理解，解释和传达风险方面遇到的困难。