No firm conclusions can be drawn from statin study in elderly

6 September 2018        

Category: BHF Comment

No firm conclusions can be drawn from a new study suggesting that statins don't reduce the risk of heart attack and stroke in relatively healthy people aged over 75, according to our Associate Medical Director.an assortment of pills

The study, published in the British Medical Journal, suggests statins are not associated with a reduction in heart and circulatory disease or death in healthy people aged over 75. However, in those with type 2 diabetes, statins were associated with a reduced risk of heart attacks and stroke as well as death from any cause, in people up to the age of 85.

However, the study was observational meaning it could not prove the true effect of statins on people in the study, and there may have been other unmeasured factors involved.  Furthermore, previous clinical trials – a more suitable method for testing the effectiveness of a drug - have suggested that statins do lower the risk of heart attack and stroke in people over 75 with no history of heart disease.  

Responding to the study, our Associate Medical Director Professor Jeremy Pearson, said:

“Old age itself – particularly reaching the age of 80 and above - puts people at increased risk of a heart attack or stroke. This risk can be heightened by factors such as high cholesterol, diabetes and high blood pressure, even in those who are otherwise seemingly healthy.”

“Previous clinical trials – which are a better measure than observational studies like this - have suggested that statins can contribute to a reduction in risk of a heart attack or stroke in elderly people with no history of heart disease. However, further trials are needed to better understand how effective they are in this age group. Regardless of age, those who have suffered a heart attack or stroke will benefit from taking a statin.

“In line with current guidance, the most important thing is that GPs have a discussion with their elderly patients to help them understand their personal risk of a heart attack or stroke, so they can make an informed decision about taking statins.”

The study

The research was led by teams at the University Institute for Primary Care Research Jordi Gol and Girona Biomedical Research Institute. Using data from the Catalan primary care system database (SIDIAP), they identified 46,864 people aged 75 years or more with no history of heart and circulatory disease between 2006 and 2015. 

Individuals were grouped into those with and without type 2 diabetes and as statin non-users or new users. They were then tracked for an average of 5.6 years to find those who developed heart and circulatory disease or died. In those without diabetes, statins were not associated with a reduction in risk or death. In those with diabetes, however, statins were associated with reduced risk of heart and circulatory disease (24%) and death (16%) in those aged 75-84 years. But this protection appeared to decline after the age of 85.

However, the researchers themselves acknowledge that there may be unmeasured factors that may have influenced the outcome, and that clinical trials are needed to fully understand the benefits of statins in this age group.

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