Statins Are Ineffective For Primary Prevention in Older Adults

No benefits were observed in older adults with moderate hyperlipidemia and hypertension and  given statin therapy for primary cardiovascular prevention, according to the results of a recent study.

Although statin therapy for primary prevention has been associated with reductions in cardiovascular morbidity, its effects on all-cause mortality are less well understood. For their study, the researchers conducted post hoc secondary data analyses of ambulatory adults with hypertension and without baseline atherosclerotic cardiovascular disease, aged 65 years and older. The participants were either assigned to pravastatin sodium (40 mg/d) or usual care.
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The baseline mean low-density lipoprotein cholesterol (LDL-C) levels were 147.7 (19.8) mg/dL in the pravastatin group and 147.6 (19.4) mg/dL in the usual care group, and by year 6, the mean LDL-C levels were 109.1 (35.4) mg/dL in the pravastatin group and 128.8 (27.5) mg/dL in the usual care group.

At year 6, 16.6% patients assigned to the pravastatin group were not taking any statin, and 71% in the usual care group were not taking any statin. Hazard ratios for all-cause mortality in the pravastatin group vs the usual care group were 1.18 for adults aged 65 years and older, 1.08 for adults aged 65 to 74 years, and 1.34 for adults 75 years and older.

“No benefit was found when pravastatin was given for primary prevention to older adults with moderate hyperlipidemia and hypertension, and a nonsignificant direction toward increased all-cause mortality with pravastatin was observed among adults 75 years and older,” the researchers concluded.

—Michael Potts

Reference:

Han BH, Sutin D, Williamson JD, et al. Effect of statin treatment vs usual care on primary cardiovascular prevention among older adults. JAMA Intern Med. 2017;177(7):955-965.