Most people over 70 should consider taking statins, study finds

According to researchers, most people over 70 should consider taking statins, as they are cost-effective and improve health in this age group.

Heart disease and strokes are leading causes of death and disability worldwide. As we age, our risk of heart disease or stroke increases. Statins have been shown to reduce that risk by lowering levels of “bad” cholesterol – low-density lipids – in the blood and are widely used by middle-aged patients. But they are less commonly used by people over 70.

A study has now shown that statin treatment should be considered for most people over the age of 70.

Borislava Mihaylova, associate professor at Oxford Population Health and lead author of the study, said: “Many people around the world suffer from preventable heart disease and stroke due to inadequate access to effective, low-cost treatments such as statins.” Improving access to statins for older people could improve their health and would be cost-effective, she added.

The study, published in the scientific journal Heart, assessed the health benefits of statins for older people in the UK, finding that they were cost-effective and led to better health outcomes in people over 70, regardless of whether patients had a history of cardiovascular disease.

Individual patient data from large-scale statin trials in the UK were examined and predicted how statin therapy might affect the risk of developing heart disease, health-related quality of life and healthcare costs over their lifetime.

The researchers then calculated how much benefit it would be to take statins in more than 20,000 elderly people, with and without a history of cardiovascular disease.

They found that taking statins significantly improved quality of life, 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 a treatment to be good value 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 less than £12,000 for higher intensity therapy – well below the Nice threshold.

In elderly people without a history of cardiovascular disease, the risk reduction was significantly smaller.

The authors cautioned that this was an observational study and therefore no causal relationship could be established.

Commenting on the findings, Prof Kamila Hawthorne, Chair of the Royal College of GPs, said: “It is encouraging to see increasing evidence that the use of statins is safe and effective for patients over 70, and it is important that this evidence is taken into account when updating clinical guidelines.”

Statins are not suitable for all patients, but GPs should prescribe them if necessary. They should also encourage people over 70 to improve their health by eating a balanced diet, not smoking and taking regular exercise, she added.

Dr Sonya Babu-Narayan, deputy medical director at the British Heart Foundation and a consultant cardiologist, said: “Statins have transformed the prevention of future heart attacks and strokes.” The new study showed the potential benefits of statins for older people, particularly given the UK’s ageing population, she added. Even taking into account the limitations of the findings, there could be “lifelong benefits for people over 70”.

Dr Mashkur Khan, chairman of the Royal Society of Medicine’s division of geriatrics and gerontology, said: “Cardiovascular risk in frail older people can be significantly reduced with the newer statins, which also have a positive effect on cognitive function and the prevention of dementia. Statins should be started early: they have an anti-inflammatory effect on blood vessels and prevent strokes and heart attacks in people with normal cholesterol levels, and help prevent complications of diabetes.”