Lifelong Statin Therapy May Benefit Quality of Life Among High-Risk Cardiovascular Disease Patients

Lifelong statin therapy may improve the lifespan for patients with a high cardiovascular disease risk, according to a new study. The quality of life among high-risk cardiovascular disease patients improved faster and larger if they took a statin earlier, and never stopped taking it.

High cholesterol is among the main risk factors for cardiovascular disease, a condition that causes the most deaths worldwide. Further, low-density lipoprotein (LDL) cholesterol may increase the risk of ischemic heart disease or stroke, but statins could reduce these risks by upwards of 25%.

“The study indicates that people in their 40s with a high likelihood of developing cardiovascular disease, and people of all ages with existing heart disease, should be considered for immediate initiation of cholesterol lowering treatment,” said lead author Runguo Wu of Queen Mary University in London, in a press release.

Statins have become the most widely used lipid-modifying drug, which guided Wu’s research toward understanding how long patients should take statins to experience benefits. His team collected data on 118,000 participants from the Cholesterol Treatment Trialists’ (CTT) Collaboration. They also analyzed data from 500,000 individuals in the UK Biobank population cohort.

The investigators used a microsimulation model to evaluate a patient’s annual risk of heart attack, stroke, coronary revascularization, diabetes, cancer, vascular death, and nonvascular death. These risks were based on personal characteristics and disease history.

The benefits of statin therapy were then measured in quality-adjusted life years (QALYs), which describes how health adjusts length of life to reflect quality of life. A QALY equates to a year of perfect health.

Researchers evaluated the benefitted QALYs among different age groups and different timespans taking 40 mg statin therapy. The participants were divided into 3 groups, the first of which was comprised of participants who took a daily 40 mg dose over their lifetime.

Group 2 took 40 mg of statin daily, but only until 80 years of age. The last group was comprised of individuals 45 years of age or younger who had either high or low cardiovascular risk and who waited 5 years before beginning statin therapy.

The team found that statin therapy increased QALYs, especially later in life. The 10-year cardiovascular risk patients benefited more and faster on a lifelong statin therapy compared to low-risk patients who discontinued the therapy at age 80.

Further, patients aged 45 years or less with high cardiovascular risk who delayed using a statin lost 7% of possible QALY from daily lifelong therapy of 40 mg of statin.

“This is because people at higher cardiovascular risk start to accrue benefit early on and have more to lose by delaying statin therapy than those at low risk,” Wu said in the press release.

He added that individuals who begin statin therapy in their 50s but stop by 80 years of age instead of continuing lifelong therapy lose 73% of the QALY benefit if they have a relatively low cardiovascular risk vs 36% among those with a high cardiovascular risk. This is because those with an elevated risk start to benefit earlier, according to Wu.

He further explained that women would especially reap the benefits of taking statins later in life because their risk of cardiovascular events increases later in life.

“Stopping treatment, unless advised by a doctor, does not appear to be a wise choice,” Wu concluded in the press release.

Reference

European Society of Cardiology. Study highlights lifelong benefits of statin therapy. EurekAlert! August 25, 2022. Accessed on August 25, 2022.