Statins 'ineffective for heart disease in elderly'

23rd May 2017 – Taking a type of statin as a precautionary measure to guard against heart disease may not be effective in older people, a US study suggests.

However, UK experts say the statin under examination has largely been phased out in favour of a new generation of the drug and that further research is warranted.

Cholesterol-lowering

Many people take statins to help lower levels of the so-called 'bad cholesterol', low-density lipoprotein (LDL) in their blood.

Studies have suggested that statins can save thousands of lives a year in the UK by helping to prevent heart disease, heart attacks and strokes. However, their use has been controversial, with plenty of publicity focusing on the side-effects that may include muscle pain and weakness.

Researchers from New York University School of Medicine say information on the risks and benefits of statins is limited among people aged 75 and over.

Pravastatin

So, they analysed data from a group of people aged 75 and over and compared the results with another group aged 65 to 74.

All the 2,867 people had high blood pressure but were not showing a build-up of plaque in their arteries that would indicate cardiovascular disease.

Of this group, 1,467 were taking the stain pravastatin and 1,400 were receiving other standard care from their doctor to lower their cholesterol levels.

The study, published in JAMA Internal Medicine, found no benefit among those taking pravastatin in reducing the risk of dying from any cause or of developing coronary heart disease, compared with those receiving normal care.

In fact, more people taking the statin died during the 6-year follow up than those in the other group. Among the 65 to 74 year olds there were 141 deaths in the statin group compared to 130 in those not taking the medication. Among those aged 75 the difference was even more marked, with 92 deaths versus 65.

There were 76 cases of heart disease in the statin group compared with 89 in the 'usual care' group among adults 65 to 74. Among those aged 75 and older there were 31 cases of heart disease in the statin group and 39 in the other group, the study found.

The researchers report that rates of stroke, heart failure and cancer were similar among those in both treatment groups.

Expert opinion

The researchers acknowledge that the strength of their findings is limited because they analysed data from a sub-group of an existing trial. Nevertheless, they say the results show that the decision whether to prescribe statins should be based on an individual assessment rather than by age alone.

Experts have reacted to the findings in statements. Dr Amitava Banerjee, honorary consultant cardiologist at University College London (UCL), says one drawback with the study is that pravastatin is an older type of statin which has largely been replaced with newer types such as simvastatin, atorvastatin and rosuvastatin.