July 14, 2024

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New Study: Statins Reduce Cardiovascular Risk Even Benefiting the Elderly!

New Study: Statins Reduce Cardiovascular Risk Even Benefiting the Elderly!



Breaking Controversy? New Study: Statins Reduce Cardiovascular Risk Even Benefiting the Elderly!

Statins have long been considered a cornerstone in lipid-lowering therapies. However, there has been no clear consensus on whether individuals over 75 years old should use statins. Guidelines from the European Society of Cardiology, the European Atherosclerosis Society, and the U.S. Preventive Services Task Force have not provided specific recommendations for statin use in this age group for primary prevention of cardiovascular diseases. This lack of guidance is partly due to the insufficient representation of elderly individuals in randomized clinical trials (RCTs) evaluating statins, which limits direct evidence for their primary prevention efficacy in this population. Additionally, the potential risks of statins, such as myopathy and liver disease, raise questions about whether the benefits outweigh the harms in older adults.

Recently, the Annals of Internal Medicine published a simulation study based on real-world electronic health records. This study explored the efficacy and risks of statin use for primary prevention of cardiovascular diseases in older adults (75-84 years) and the very elderly (≥85 years).

The findings indicated that statin use was associated with a reduced risk of cardiovascular diseases, even in those over 85 years old. Furthermore, statins did not increase the risk of adverse events, such as myopathy and liver dysfunction, in the elderly.

New Study: Statins Reduce Cardiovascular Risk Even Benefiting the Elderly!

 

Researchers included 440,740 eligible participants from 96 “trials,” all of whom were not using statins or other lipid-lowering medications at baseline and had no cancer, myopathy, or liver dysfunction. The researchers used software to simulate a series of targeted trials. Given the consensus on the efficacy of statins in individuals under 75, the researchers used the 60-74 age group (73,427 participants) as a “standard” to observe the outcomes in the 75-84 age group (21,340 participants) and the ≥85 age group (2,695 participants). They matched the three groups with corresponding control groups in a 1:1 ratio.

The average follow-up time for all eligible individuals was 5.6 years, with an average of 5.3 years for those aged ≥75. Researchers analyzed cardiovascular disease and all-cause mortality rates in the intention-to-treat (ITT) and per-protocol (PP) populations. The results were as follows:

  • 60-74 age group: The overall cardiovascular disease risk was low. In the ITT population, the relative risk was reduced by 11% (HR=0.89, 95%CI: 0.86-0.92), and in the PP population, the relative risk was reduced by 23% (HR=0.77, 95%CI: 0.72-0.83).

  • 75-84 age group: Statin therapy initiation led to a reduction in overall cardiovascular risk. In the ITT population, the cardiovascular risk was reduced by 6% (HR=0.94, 95%CI: 0.90-0.98), with a 1.2% reduction in the 5-year standardized absolute risk. In the PP population, the risk was reduced by 21% (HR=0.79, 95%CI: 0.68-0.93), with a 5% reduction in the 5-year standardized absolute risk. For every 20 individuals using statins, 1 cardiovascular event was prevented over 5 years.

  • ≥85 age group: In the ITT population, the cardiovascular risk was reduced by 15% (HR=0.85, 95%CI: 0.77-0.94), with a 4.33% reduction in the 5-year standardized absolute risk. In the PP population, the risk was reduced by 35% (HR=0.65, 95%CI: 0.55-0.76), with a 12.5% reduction in the 5-year standardized absolute risk. For every 8 individuals using statins, 1 cardiovascular event was prevented over 5 years.

Additionally, the study did not observe an increased risk of myopathy or liver dysfunction in any age group.

In conclusion, the results of this simulation study suggest that statin therapy in individuals over 75 years old can reduce the risk of cardiovascular diseases without increasing adverse events. Notably, these benefits and safety extend to those aged ≥85 years.

New Study: Statins Reduce Cardiovascular Risk Even Benefiting the Elderly!

(source:internet, reference only)


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