Most people over 70 should consider taking statins, researchers say, adding that they are cost-effective and linked to better health outcomes for the age group.
Heart disease and stroke are leading causes of death and disability globally. As we age, our risk of heart disease or stroke increases. Statins are proven to reduce that risk by reducing levels of “bad” cholesterol – low-density lipids – in the blood and are widely used by middle-aged patients. But they are less commonly taken by those over 70.
Now a study has concluded that statin treatment should be considered for most people aged over 70.
Borislava Mihaylova, an associate professor at Oxford Population Health and the lead author of the study, said: “Many people around the world are suffering from preventable heart disease and stroke due to insufficient access to effective low-cost treatments such as statins.” Improving access to statins for older adults could improve their health and this would be cost-effective, she added.
The study, published in the academic journal Heart, assessed the health benefits of statins for older people in the UK and found that they were cost-effective and linked to better health outcomes in the over-70s, whether or not patients had a history of cardiovascular disease.
It examined individual patient data from large-scale UK statin trials and predicted how statin therapy could influence their likelihood of developing heart disease, their health-related quality of life, and health-related care costs over their lifetimes.
The researchers then calculated the value of taking statins for more than 20,000 older people, with and without a history of cardiovascular disease.
They found that taking statins significantly increased quality-adjusted life years, especially at higher intensity doses. Quality-adjusted life years is a measure used by the National Institute for Health and Clinical Excellence to assess whether a treatment is worth providing on the NHS. According to Nice, the threshold for good value treatment is less than £20,000 for each quality-adjusted life year gained.
The cost for each quality-adjusted life year gained was less than £3,500 for standard statins and below £12,000 for higher-intensity therapy – well below the Nice threshold.
For older people with no history of cardiovascular disease, the reductions in risk were substantially smaller.
The authors cautioned that this was an observational study, and as such, could not establish cause and effect.
Responding to the findings, Prof Kamila Hawthorne, the chair of the Royal College of GPs, said: “It’s encouraging to see further evidence that the use of statins is safe and effective for patients over 70, and it is important this evidence is taken onboard as clinical guidelines are updated.”
While statins would not be suitable for all patients, GPs would prescribe statins where appropriate, alongside encouraging over-70s to improve their health by eating a balanced diet, not smoking, and exercising regularly, she added.
Dr Sonya Babu-Narayan, the associate medical director at the British Heart Foundation and a consultant cardiologist, said: “Statins have transformed prevention of future heart attacks and strokes.” The new study showed the potential benefits of statins for older people, especially given the UK’s ageing population, she added. Even accounting for limitations in its findings, there may be “lifetime benefits for the over-70s”.
Dr Mashkur Khan, the president of the geriatrics and gerontology section of the Royal Society of Medicine, said: “Cardiovascular risk in the frail elderly can be significantly reduced with the newer statins, which also have a positive effect on cognitive abilities and the prevention of dementia. Statins should be started early: they have an anti-inflammatory effect on the blood vessels and prevent strokes and heart attacks in people who have even normal cholesterol, as well as helping prevent complications of diabetes.”
