Statins Safe for Primary CVD Prevention in Old, Very Old: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On July 10, 2024, we reported on findings from a study published in the Annals of Internal Medicine that examined the benefits and risks of using statins for primary prevention of cardiovascular disease (CVD) in old (aged 75 to 84 years) and very old (aged ≥85 years) adults.

The study

Researchers tapped real-world data from territory-wide public electronic health records in Hong Kong collected between January 2008 and December 2018. Study eligibility required age of 75 years or older, suboptimal lipid levels and risk factors for CVD, including diabetes.

A total of 69 981 individuals aged 75 to 84 years and 14 555 aged 85 years and older were considered eligible for analysis. Among 42 680 matched person-trials aged 75 to 84 years, and 5390 matched person-trials aged 85 years and older, 9676 and 1600 participants developed CVD in each age group, respectively (mean follow-up, 5.3 years).

The findings

The use of statin therapy was associated with significant reductions in the primary CVD composite endpoint of 6% in the 75- to 84-year-old group and of 15% in the 85 years and older group. The incidence of CVD events over 5 years in statin users was 1.2% (95% CI, 0.57% to 1.82%) lower in the 75- to 84-year-old cohort and 4.4% (95% CI, 1.40% to 7.48%) lower in the older cohort compared with participants not taking statins.

In the per protocol analysis, the relative reductions in CVD events were 21% and 23% in the old and very old groups, respectively. CVD incidence was lower by 5% in statin users aged 75- to 84-years-old and by 12.5% in those aged 85 years and older.

Authors' comment

"The innovative approach adopted in this study has the potential to generate high-quality evidence in the field of geriatric medicine, thereby advancing our understanding and improving healthcare outcomes for older populations."

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