Paris, France—The use of preventive medications in older adults has caused debate in medical circles. One example is the use of statins in healthy seniors, aged 75 years and older, with no previous history of cardiovascular disease (CVD), according to a recent study.

The report in the European Heart Journal points out that statins are proven to reduce the risk of recurrent cardiovascular events in patients of any age who have already had issues such as acute myocardial infarction or stroke. What has been unknown, however, is the benefit of the cholesterol-lowering drugs in patients without CVD history, especially if they are older.

To determine that, researchers from Pitié-Salpêtrière Hospital—part of Assistance Publique-Hôpitaux de Paris—conducted a nationwide study of 120,173 people in France from 2012 to 2014. Participants reached age 75 years during that time period and had been taking statins continuously for 2 years.

Their results documented that the older adults who stopped statins had a 33% increased risk of being admitted to a hospital with heart or blood-vessel problems during an average follow-up period of 2.4 years.

“To patients, we would say that if you regularly take statins for high cholesterol, we would recommend you don’t stop the treatment when you are 75,” emphasized lead researcher Philippe Giral, MD, PhD, an endocrinologist and specialist in prevention of CVD. “To doctors, we would recommend not stopping statin treatment given for primary prevention of cardiovascular diseases in your patients aged 75.”

Giral also called for a randomized clinical trial before guideline updates are considered.

The study discusses how the role of statin therapy in primary prevention of cardiovascular disease in persons older than age 75 years “remains a subject of debate with little evidence to support or exclude the benefit of this treatment.“

For purposes of the study, statin discontinuation was defined as 3 consecutive months without exposure, while the primary outcome was designated as hospital admission for a cardiovascular event.

Researchers report that 14.3% of the study group discontinued statins, and 4.5% were admitted for a cardiovascular event. The adjusted hazard ratios for statin discontinuation were calculated as:
• 1.33 (95% CI, 1.18-1.50) (any cardiovascular event)
• 1.46 (95% CI, 1.21-1.75) (coronary event)
• 1.26 (95% CI, 1.05-1.51) (cerebrovascular event), and
• 1.02 (95% CI, 0.74-1.40) (other vascular event)

“We estimated that an extra 2.5 cardiovascular events per 100 people would occur within four years among those who discontinued their statins at the age of 75 years compared to those who continued taking their statins,” Giral explained.

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