September 2, 2015
Very Old Have High Rate of Statin Use Despite Little Evidence of Effectiveness

Columbus, OH—Prescriptions for statins are extremely high in the very elderly, even though little evidence basis exists for the use of the cholesterol-lowering drugs in that population, according to recent research.

In fact, patients older than 79 have the highest rate of statin use in the United States, according to the research letter published recently in JAMA Internal Medicine. Background information in the study points out that little evidence-based research has been conducted involving patients that old.

A study team led by investigators from The Ohio State University Wexner Medical Center analyzed data of 13,099 individuals from the 1999-2012 Medical Expenditure Panel Survey, which is nationally representative of the general population each year. The survey included five interviews over 2 years and contained self-reported demographics, medical conditions, and prescription drug information.

For the study, primary prevention was defined as individuals without vascular disease, including coronary heart disease (CHD), stroke, or peripheral vascular disease, while secondary prevention was defined as individuals with vascular disease.

The authors found rates of vascular disease in the population increased from 27.6% in 1999-2000 to 43.7% in 2011-2012—especially after 2007, when questions regarding CHD and stroke were asked more frequently. At the same time, the rate of statin use for primary prevention increased from 8.8% in 1999-2000 to 34.1% in 2011-2012, according to the results.

“We found high rates of statin use in primary prevention among patients older than 79 years old who didn’t have vascular disease,” lead author Michael Johansen, MD, a family medicine physician, said in an OSU press release. “We observed an increasing trend in statin use in both primary and secondary prevention, but didn’t find that high potency statin use was associated with vascular disease.”

Which statins were used varied across time.

The proportion of patients using atorvastatin peaked in 2005-2006 and then steadily declined, according to study authors, while the proportion using simvastatin was steady until 2007-2008, when it started to rise. The percentage of statin users taking rosuvastatin steadily increased after its regulatory approval in the United States in 2003, the authors point out.

“Although the medical community has embraced the use of statins for primary prevention in the very elderly,” study authors conclude, “caution should be exercised given the potential dangers of expanding marginally effective treatments to untested populations.”

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