Statins can safely cut risk of heart attacks or strokes in healthy people aged over 70, world-first clinical trial shows

Australian-led trial finds low risk of side effects from common cholesterol-lowering medication for otherwise healthy older people

Taking a common cholesterol-lowering medication can reduce the risk of a heart attack or stroke for people aged over 70, with a low risk of serious side effects, a world-first clinical trial led by Australian researchers has found.

Statins are already commonly prescribed to people under the age of 75 who meet certain risk criteria, such as having diabetes and high cholesterol, to prevent them from having a major heart event such as a heart attack, stroke, or from requiring heart surgery.

People who have already had a major heart event are also commonly prescribed the drugs, regardless of their age.

What doctors did not know was whether it was safe to prescribe a daily statin to people aged 70 and over who were healthy overall, having never experienced a heart attack, stroke or heart surgery, and whether doing so could prevent these cardiac events.

A co-author of the study, Adjunct Prof Mark Nelson with the Monash University school of public health and preventive medicine, said it was an important piece of missing information, because the biggest risk of major heart-related events “is increasing age”.

“Our society is ageing, and therefore the burden of disease is increasing, making it important to improve our ability to prevent disease in this group,” he said. “So we needed the evidence for this group to see if prescribing statins as a prevention measure works.”

But Nelson said older adults were often overlooked in early statin research because 40 years ago, heart disease was most common in middle-aged populations especially if they smoked, leading public health efforts to focus on preventing premature deaths in that group. Elderly populations may also be sick and on other medications, making trialling drugs risky, he said.

To address the gap, Monash researchers analysed the cardiovascular outcomes of almost 10,000 study participants over the age of 70 who were given either a daily statin or a placebo, in a scientifically-robust type of study known as a randomised control trial. The participants were enrolled with the help of almost 3,400 GPs across Australia.

The researchers excluded people who had a condition that might make taking a statin unsafe, if they were not living independently, or if they already needed the drug because they had suffered a heart attack.

The decade-long study found the medication decreased the risk of a first major cardiovascular event by 30% for those aged over 70.

In real terms, this means one major cardiac event such as a heart attack, stroke, or heart surgery could be prevented for every 37 older adults treated with daily statins over almost six years.

Prof James Chong, a cardiologist at Sydney’s Westmead hospital, said if the research “leads to increased statin use globally, the absolute reduction of (heart-related) events can be significant”.

“One of the major changes that may result, in my opinion, is more elderly patients having confidence to take long term statins,” he said.