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Value of statins in the elderly confirmed

Starting statins reduces the risk of all-cause and cardiovascular mortality among people aged 75 years and older who were free from atherosclerotic cardiovascular disease (ASCVD) at baseline, a new study finds. 

The study enrolled 326,981 people aged, on average, 81.1 years. More than nine in 10 were male and white (97 and 91 per cent). Of these, 17.5 per cent started statins, usually simvastatin (84.8 per cent) or lovastatin (11.0 per cent).

During a mean follow-up of 6.8 years, overall mortality was 78.7 and 98.2 per 1,000 person-years among statin users and non-users respectively. 

The cardiovascular death rate was found to be 22.6 and 25.7 per 1,000 person-years respectively.

The rates of a composite of ASCVD events (myocardial infarction, ischaemic stroke and revascularisation with coronary artery bypass graft surgery or percutaneous coronary intervention) were 66.3 and 70.4 events per 1,000 person-years among statin users and non-users respectively. 

After allowing for confounders, statin users were 25 per cent less likely to die from any cause, 20 per cent less likely to die from cardiovascular causes and 8 per cent less likely to experience an event from the ASCVD composite. The mortality reduction was consistent in statin users 90 years and older as well as those with dementia. 

The study enrolled relatively few women and people of non-white ethnicity and assessed neither adverse effects of statins nor the effect of discontinuation.

The authors conclude that, “further research is needed to more definitively determine the role of statin therapy in older adults for primary prevention of ASCVD”.

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