Statin Use Over 65 Years of Age and All‐Cause Mortality: A 10‐Year Follow‐Up of 19 518 People

Abstract

OBJECTIVES As life expectancy continues to rise, the burden of cardiovascular disease among older people is expected to increase, making cardiovascular prevention in older people an issue of growing interest and public health importance. We aimed to explore the long‐term effects of adherence to statins on mortality and cardiovascular morbidity among older adults. DESIGN A historical population‐based cohort study using routinely collected data. SETTING Clalit Health Services Northern District. PARTICIPANTS We followed members of Clalit Health Services aged 65 years or older who were eligible for primary cardiovascular prevention for a period of 10 years. MEASUREMENTS We fitted Cox regression models to assess the association between the adherence to statin therapy and all‐cause mortality and cardiovascular morbidity, adjusting for cardiovascular risk factors and associated morbidity as time‐updated variables. RESULTS The analysis included 19 518 older adults followed during 10 years (median = 9.7 y). All‐cause mortality rates were 34% lower among those who had adhered to statin treatment, compared with those who had not (hazard ratio [HR] = .66; 95% confidence interval [CI] = .56‐.79). Adherence to statins was also associated with fewer atherosclerotic cardiovascular disease events (HR = .80; 95% CI = .71‐.81). The benefit of statin use did not diminish among beyond age 75 and was evident for both women and men. CONCLUSION Adherence to statins may be associated with reduced mortality and cardiovascular morbidity among older adults, regardless of age and sex. J Am Geriatr Soc 67:2038–2044, 2019

Intensity of statin therapy and muscle symptoms: a network meta-analysis of 153 000 patients

“…Discontinuation of statins in the elderly (>75 Open access years) may result in 33% increased risk of a cardiovascular event within 3 months 53 and adherence to statins in those 65 years and older may reduce mortality by a third. 54 Myalgias and attrition due to SAMS are important outcomes for the average patient but have not received as much attention as rhabdomyolysis and myopathy. This study provides evidence that while blinded, moderate intensity statin takers did not report significantly more general muscle problems or myalgias, but those on high intensity therapy did.…”

Statin therapy for primary cardiovascular prevention in adults older than 75 years

“…Statin therapy reduced the risk of stroke, cerebrovascular disease, and CVD related events in the elderly. Eilat et al conducted a historical population-based cohort study and found that both men and women on a statin greater than the age of 75 experience fewer atherosclerotic CVD events compared to those not on a statin [24]. Furthermore, a population-based cohort study conducted in France in 2019 analyzed 120 173 patients above the age of 75 who were taking statins [25].…”

Guidelines for the Diagnosis and Management of Chronic Coronary Syndromes in Primary Health Care – the Issue of Acceptability for the Russian Federation

“…С нашей точки зрения, такой подход требует широкого врачебного обсуждения и согласования, поскольку совершенно точно это повлечет за собой: а) дальнейший рост показателей заболеваемости ишемической болезнью сердца (болезнью коронарных артерий) за счет установления диагноза всем обратившимся за медицинской помощью при наличии факторов риска развития сердечно-сосудистых осложнений; б) назначение необоснованной терапии. Вопросы медикаментозного, эндоваскулярного и хирургического лечения (с учетом данных, не отраженных в рекомендациях ESC [17][18][19][20][21][22][23]), также требуют согласования.…”