August 01, 2019
Older patients who discontinue primary prevention statin treatment are significantly more likely to be hospitalized for cardiovascular events than those who continue treatment, according to the results of a recent study.
Although the benefits of statin therapy have been well established for secondary prevention in all age groups, there is little available evidence either for or against their use for primary prevention in older adults.
In order to explore the effects discontinuation of statins for primary prevention in this age group, researchers conducted a population-based cohort study using data from French national health care databases including 120,173 adults who turned age 75 in 2012-2014 and who had no history of cardiovascular disease.
Of the 120,173 patients, 17,204 (14.3%) discontinued statins (defined as 3 consecutive months without exposure) and 5396 (4.5%) were hospitalized for a cardiovascular event.
Overall, the adjusted hazard ratios for statin discontinuation were 1.33 for any cardiovascular event, 1.46 for a coronary event, 1.26 for a cerebrovascular event, and 1.02 for other vascular events.
“The results of this study suggest potential cardiovascular risk reduction associated with continuing statin therapy after the age of 75 years in persons already taking these drugs for primary prevention. However, due to the observational nature of this study, residual confounding cannot be excluded. Future studies, including interventional randomized studies, are needed to confirm these findings and support updating and clarification of guidelines on the use of statins for primary prevention in the elderly,” the researchers concluded.
Giral P, Neumann A, Weill A, Coste J. Cardiovascular effect of discontinuing statins for primary prevention at the age of 75 years: a nationwide population-based cohort study in France [published online July 30, 2019]. European Heart Journal. https://doi.org/10.1093/eurheartj/ehz458.