Study results do not support widespread use of statins in old and very old populations

Statins do not prevent the development of atherosclerotic cardiovascular disease (CVD) in people without diabetes aged 75 years and over, according to a study published in the BMJ (online, 5 September 2018)^[1]
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Researchers used primary care data on 46,864 people in Catalonia, Spain, with no history of atherosclerotic CVD split into two age groups: those aged 75–84 years and those aged 85 years and older. Participants were stratified by presence of type 2 diabetes and as statin non-users or new users.

Over a median follow-up of 5.6 years, there was no significant difference in the risk of atherosclerotic CVD or all-cause mortality between those who received statins and those who did not in either age group.

However, in the younger age group, those with diabetes had a 24% reduced risk of atherosclerotic CVD and a 16% reduced risk of death when they took statins. But this effect was substantially reduced after the age of 85 years and disappeared in those aged 90 years and over.

The researchers explained that while the effectiveness of statins in the secondary prevention of cardiovascular events was well established in those aged 75 years and over, there was less evidence to inform primary prevention.

“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 team concluded.