While statins are regularly prescribed to millions of people around the world, debate continues over the effectiveness of the cholesterol-lowering medication. Some claim they do wonders for health, while others question the effectiveness of the drug and who benefits the most from taking them.
In most cases, statins are prescribed to those in the community most at risk of developing cardiovascular disease as they prevent the risk of heart attacks, strokes and other cardiovascular problems. They work by lowering levels of low-density lipoprotein (LDL), which is also known as bad cholesterol. High levels of LDL can cause arteries to harden and narrow.
The latest research, published in the Lancet Journal, has found statin therapy is safe and effective in older people, especially those over the age of 75 who don’t already have heart disease.
The meta-analysis uses evidence from 28 randomised controlled trials of 186,854 patients. This includes 14,483 people aged over 75. For the purpose of the study, participants were split into six different age groups to assess the effects of statins on major health issues including heart attacks, strokes, cancer and even death.
“Statin therapy has been shown to prevent cardiovascular disease in a wide range of people, but there has been uncertainty about its efficacy and safety among older people over 75 years,” lead investigator Anthony Keech said in a statement. “
Our study summarised all the available evidence from major trials to help clarify this issue, and found that there were significant reductions in major vascular events in each of the six age groups considered, including in patients aged over 75 years at the start of treatment.”
Previous trials consider “elderly” people over the age of 65, but because life expectancies have increased due to medical advancements, this is no longer the case. Researchers discovered statin treatment reduces the risk of major vascular health events by a quarter for each millimole per litre reduction in LDL cholesterol.
In addition, researchers saw similar results across all ages – including people over the age of 75. The results also found statin therapy didn’t increase the risk of deaths from non-cardiovascular disease or the risk of cancer.
Cardiovascular risk reductions were observed across all age groups at the start of the trial, but researchers said there was less definitive evidence for over-75s. Still, researchers are hopeful that the medication can still help people in this age group.
“Our analysis found that statin therapy appears to be just as effective in people aged over 75 years as it is in younger people. We now have definitive evidence that statins benefit older people who have suffered a heart attack or stroke.” Co-investigator Jordan Fulcher said. “This study will provide reassurance and guidance for doctors and patients alike that people are not automatically “too old” for treatments like statins to be effective.”
Researchers also said that the risk of heart attack and stroke increases with age, but statins aren’t being used as widely as they could be for older people.
“Since the risk of heart attack and stroke increases with age, the potential benefits are likely to be even greater for older people,” co-investigator Colin Baigent said in a statement. “Therefore, there is a need to ensure that patients at risk of cardiovascular disease due to their age are offered statin therapy where there is good reason to believe that it will be beneficial. Anyone with concerns about whether statin therapy is suitable for them should discuss this with their GP.”
The results of the study have drawn responses from those in the health profession, including Emeritus Professor Mark Wahlqvist, who said the study was “disturbing” for what it doesn’t show.
“The comparators do not include non-statin approaches that we know to improve disability-adjusted life expectancy (DALYS),” he said in a statement to Scimex. “Aside from gender, smoking, social infrastructure, health care, education and nature itself, dietary patterns which are plant-based, biodiverse and not contaminated by the likes of endocrine disruptors, are what have accounted for the striking improvements we have seen in DALYS in later life.”
Meanwhile, Garry Jennings, Chief Medical Advisor of the Heart Foundation, believes more studies needed to be conducted. He told Scimex: “In summary the analysis provided strong support for the use of statins in people aged over 75 who have a history of heart or vascular disease, probable benefit for people aged over 75 without a history of heart or vascular disease and no support for their routine use in older people with heart failure or on dialysis treatment.
“Fifteen thousand is a large number, but given the diversity of studies included in the meta-analysis, it is not enough to provide a definitive answer to the question of who benefits from statins at an older age.”
It’s always important to discuss the use of statins with a health professional.