Statins Offer Little Benefit to Healthy Older Adults

Although statins have been linked to benefits among older patients with cardiovascular disease (CVD), the results of a recent study indicate that there is insufficient evidence to recommend the drug class’ widespread use in healthy adults over the age of 75.¹

The study, published in The BMJ, analyzed 2006-2015 data on 46,864 patients aged 75 years or older with no history of CVD. These participants were placed into groups based on their age, whether or not they had type 2 diabetes, and whether they were new statin users or non-users.

The research team found that, over an average of 5.6 years, the use of statin was not associated with a reduction in CVD or mortality across all age groups, even though the patients’ CVD risk exceeded the proposed risk thresholds for statin use in guidelines.

Researchers also determined that statin use was associated with a 24% reduced risk of CVD and a 16% reduced risk of mortality among patients aged 75-84 years with diabetes, suggesting that the drug class could prove beneficial to this population. However, the protection provided by statins to these patients began to decline after age 85 years and disappeared entirely by age 90.

“These results do not support the widespread use of statins in old and very old populations, but they do support treatment in those with type 2 diabetes younger than 85 years,” the study authors concluded.

The authors acknowledged that their study was observational and that no definitive conclusions about causation could be drawn from their findings, but noted that the large sample size of their research was reflective of genuine clinical conditions.

In an accompanying editorial, Aidan Ryan, MD, Simon Heath, MD, and Paul Cook, MD, wrote that further research is needed in this area, adding that “patient preference remains the guiding principle while we wait for better evidence.”²

References

• Ramos R, Comas-Cufí M, Martí-Lluch R, et al. Statins for primary prevention of cardiovascular events and mortality in old and very old adults with and without type 2 diabetes: retrospective cohort study. BMJ. Published September 5, 2018. doi: 10.1136/bmj.k3359.
• Ryan A, Heath S, Cook P. Primary prevention with statins for older adults. BMJ. Published September 5, 2018. doi: 10.1136/bmj.k3695.