Taking statins after 75 ‘nearly halves risk of heart attack’
Posted on July 31st, 2019

Courtesy The Times (UK)

Continuing to use statins after the age of 75 nearly halves the risk of a heart attack, research has suggested.

Taking the drugs into old age could also reduce the risk of a stroke by a quarter, according to the first study to focus on what happens when people aged above 75 stop using statins. Scientists have debated whether healthy older people with no history of heart-related conditions should take statins, with some arguing that there is no evidence of any benefit.

Researchers found that stopping the drugs after the age of 75 was associated with a 46 per cent higher risk of a heart attack and a 26 per cent increased chance of suffering a stroke. Overall, the French study of more than 120,000 over-75s taking statins suggested that those who stopped were 33 per cent more likely to need hospital treatment for a heart or blood vessel-related problem over the next four years than those who continued with the medication.

Statins are one of the most commonly prescribed drugs in Britain, used by about six million people. They help to prevent heart attacks and strokes by lowering levels of bad cholesterol”.

NHS guidance says that people who have a 10 per cent or higher risk of developing heart disease in the next decade should be offered statins. This includes most people aged over 75, although decisions are made on an individual basis. Previous research has suggested that about 40 per cent of over-65s prescribed statins stop taking them. In the latest study, researchers analysed data from the French national health insurance claims database, including statin prescriptions and information on hospital diagnoses and clinical procedures.

They looked specifically at patients who had turned 75 between 2012 and 2014 and had been taking statins for at least 80 per cent of the time in the previous two years but were in good health.

They followed 120,173 people for up to four years, during which time 14.3 per cent chose to stop taking statins and 4.5 per cent were admitted to hospital with a cardiovascular problem. The researchers did not have access to data on deaths.

The lead researcher, Philippe Giral, of Assistance Publique-Hôpitaux de Paris, said: We estimated that an extra 2.5 cardiovascular events per 100 people would occur within four years among those who discontinued their statins at the age of 75 years compared with those who continued taking statins.”

Researchers did not have precise information on why patients stopped taking the drugs but some ceased because they developed other health problems or started cancer treatment.

Previous research into statins and older people has been based on analysis of subsections of wider data but the latest study, published in the European Heart Journal, was the first to look exclusively at a large number of healthy over-75s who were taking statins. The research was observational, meaning it could show only an association and could not prove that stopping the drugs raised health risks.

Sir Nilesh Samani, medical director at the British Heart Foundation, said: This study, although observational, adds to evidence that statins reduce heart attacks and strokes in older people.”

Q&A: How do statins work? 
They lower cholesterol in the blood by limiting a liver enzyme which regulates its production. This helps to prevent heart attacks and strokes because high cholesterol can narrow arteries over time.

What is the problem with older people taking them?
There is conflicting evidence about whether statins benefit healthy older people with no history of heart disease or stroke. In September a Spanish study of 47,000 patients with an average age of 77 suggested that statins only helped those with type 2 diabetes, for example. Some doctors think prescribing statins to healthy people is wasteful. Side effects such as diarrhoea or headaches are reported by some users.

How could they help over-75s?

A study published in The Lancet this year suggested that giving statins to everyone over that age could save up to 8,000 lives a year. Today’s research adds weight to this claim, suggesting that when older patients continue to take them they have a lower risk of heart attacks and strokes

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