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The evidence is strong that statins are effective for treating CVD in the early stages of the disease secondary prevention and in those at elevated risk but without CVD primary prevention. Side effects of statins include muscle pain , increased risk of diabetes mellitus , and abnormalities in liver enzyme tests. High cholesterol levels have been associated with cardiovascular disease CVD. As of [update] , a number of statins are on the market: Clinical practice guidelines generally recommend people try "lifestyle modification", including a cholesterol-lowering diet and physical exercise , before statin use.

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