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Cardiovascular agents

Statins reduce risk of major vascular events in all ages, study finds

Statins reduce the risk of vascular events in people of all ages, although there is less evidence of this in people aged over 75 years than in younger patients, researchers have found.

A meta-analysis published in The Lancet (online, 2 February 2019) found that, irrespective of age, statins reduced the risk of major vascular events by 21% per 1mmol/L reduction in low-density lipoprotein (LDL) cholesterol. For major coronary events the overall reduction was 24% per 1 mmol/L reduction, but ranged from about 30% in people aged under 55 years to around 20% in people aged over 75 years.

The study looked at evidence from 28 randomised controlled trials, which included 186,854 patients — 14,483 of whom were aged over 75 years. It also found no adverse effects of statin therapy on nonvascular mortality or cancer.

Jordan Fulcher, a researcher at the Cholesterol Treatment Trialists’ Collaboration at the University of Sydney, which carried out the research, said his team had wanted to consider the evidence gap on the efficacy and safety of statins in older people.

“Our analysis indicates that major cardiovascular events were reduced by about a fifth, per mmol/L lower LDL cholesterol, by statin therapy across all age groups. Despite previous concerns, we found no adverse effect on cancer or nonvascular mortality in any age group,” he said.

Martin Marshall, vice chair of the Royal College of GPs, said it was “particularly reassuring to see evidence of benefit in patients over the age of 75 [years] — the age group most likely to need cholesterol medication, and who are at risk of heart attacks and strokes”.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206095

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