Can Statin Prevent Cardiovascular Disease in Older Adults?

Statins are drugs that reduce cholesterol and prevent the risk of cardiovascular disease. But a new study found that statins may not protect older adults against diseases.

Older adults with hypertension and moderately high cholesterol did not benefit from statin therapy, according to a new study. A research team conducted data analysis of a clinical trial that involved older adults who had taken statin for all-cause mortality or coronary heart disease events.

Many older patients take statins for primary cardiovascular prevention, but data are limited on the risks and benefits of statins for primary prevention in this age group. Improving the understanding of preventive interventions in older patients has implications for health care and its costs.

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For older adults, treatment recommendations should be personalized to prevent the risk of cardiovascular disease because statin may not prevent the risk.

Benjamin H. Han, M.D., M.P.H., of the New York University School of Medicine, and coauthors analyzed data from older adults in the Lipid-Lowering Trial (LLT) component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT), which was conducted from 1994 to 2002.

The authors used an analytical sample that included 2,867 adults with hypertension but without baseline atherosclerotic cardiovascular disease (plaque build-up in the arteries). Of the 2,867 adults, 1,467 were in the pravastatin sodium group (40 mg per day) and 1,400 received usual care from their primary care physician to lower cholesterol.

The authors report no benefit of pravastatin for the main outcome of all-cause mortality or secondary outcomes of coronary heart disease events and cause-specific mortality. More deaths occurred in the pravastatin group than in the usual care group (141 vs. 130) among adults 65 to 74 and among adults 75 and older (92 vs. 65).

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There were 76 CHD events in the pravastatin group compared with 89 in the usual care group among adults 65 to 74 and 31 CHD events compared with 39 among adults 75 and older, according to the results. Stroke, heart failure, and cancer rates were similar in the two treatment groups for both age groups.

Authors note limitations of the current study, which include its design as a post hoc secondary analysis of a trial of a subgroup of patients.

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"No benefit was found when a statin was given for primary prevention to older adults. Treatment recommendations should be individualized for this population," the article concludes.

The findings of the study is published in JAMA Internal Medicine.

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Source-Eurekalert