Research shows that statins may benefit those over the age of 70, too.
- Statins are a type of medication
that can help lower a person’s “bad” cholesterol, helping reduce their
risk for cardiovascular disease.
- Statins are generally
recommended for adults between the ages of 40 and 75 who have heart
disease risk factors.
- Despite having higher risks
for cardiovascular disease, fewer older adults use statins.
- Researchers from the
University of Oxford found statin treatment was both cost-effective and
correlated to better health outcomes in older adults with or without
previous cardiovascular disease.
Statins are
a type of medication that help lower low-density
lipoprotein (LDL) cholesterol — or “bad” cholesterol — in the
body. This helps keep the arteries clear so blood has an easier way of
traveling throughout the body.
By
reducing LDL cholesterol, statins can also help lower a person’s risk for cardiovascular
diseases such as heart failure, coronary
heart disease, heart attack,
and stroke.
The
U.S. Preventive Services Task Force (USPSTF) recommends adults between the ages of 40 to 75 who have
one or more cardiovascular
risk factors and an estimated 10-year cardiovascular disease
risk take statins to help prevent heart issues.
But
what about older adults over the age of 70 — can statins help them as well?
“Despite
high risks of heart disease and stroke in older people and high need for
preventive treatment such as statins, fewer older people use statins compared
to middle-aged people,” Borislava
Mihaylova, DPhil, associate professor and senior health economist at
the Nuffield Department of Population Health at the University of Oxford,
professor of Health Economics in the Wolfson Institute of Population Health at
Queen Mary University of London told Medical News Today.
“This
is likely due to fewer older people, particularly those without previous heart
attacks and strokes, contributing to the randomized studies of statin therapy
which has led to more limited evidence with larger uncertainty,” she said.
For
this reason, Mihaylova and her colleagues decided to re-examine the value of
statin therapy for older adults using the latest evidence and contemporary
population data.
In
the new study recently published in the journal Heart,
lead author Mihaylova and her team found statin treatment was both
cost-effective and correlated to better health outcomes in older adults with or
without previous cardiovascular disease.
Statins help lower cholesterol
For
this observational study, researchers analyzed data from the U.K. Biobank and Whitehall II study of more than 20,000 adults in the U.K.
70 years and older with or without previous cardiovascular disease.
This
data was then used in the cardiovascular disease simulation model to estimate
study participants’ heart disease risk, survival rate, quality-adjusted
life years, and healthcare costs with and without lifetime standard
or higher intensity statin therapy.
“Heart
disease and stroke are leading causes of disability and death,” Mihaylova said.
“As we age, our risk of having a heart attack or a stroke increases. Having
high levels of LDL or ‘bad’ cholesterol in your blood further increases your
risk. Statins are a type of medicine that lower levels of LDL cholesterol and
reduce risk of heart attacks and stroke.”
According
to researchers, standard statin therapy normally results in a 35-45% reduction
in LDL cholesterol, while higher-intensity treatment lowers LDL cholesterol by
45% or more.
Lifetime statin use
increases quality-adjusted life years
Upon
analysis, scientists found that participants who stayed on standard statin
treatment for their lifetime increased their quality-adjusted life years by
0.24-0.70, and those on higher-intensity statin therapy raised their
quality-adjusted life years by another 0.04-0.13.
“We previously
looked into the effects of statin therapy in middle-aged
people,” Mihaylova said.
“The
effects of statin therapy reported here across people 70 years of age and older
are, as expected, a bit smaller but sizeable. These results complete the
picture of likely substantial health benefits with statin therapy across the
continuum of age and risk levels in the population,” she continued.
Statin treatment ‘good
value’ for older adults
When
examining the cost-effectiveness of statin use in older adults, the researchers
report that statins were cost-effective, with the cost per quality-adjusted
life years gained below £3,502 (about $4,560) for standard therapy and below
£11,778 (about $15,340) for higher intensity therapy.
This,
the scientists say, is well under the current threshold for good value
interventions of about £20,000 (about $26,000) per quality-adjusted life years
gained.
“This
finding indicates that statin treatment is likely to be of good value-for-money
across people over 70 years old,” Mihaylova explained.
“The additional cost for the additional health gained
with statin therapy is well under what is considered ‘good buy’ for the NHS. It
was also reassuring to see that statins remained of good value — although with
greater uncertainty — in further analysis assuming smaller risk reductions with
statin therapy in older people without previous cardiovascular disease.
Overall, our findings suggest that more people over 70 years of age should be
considered for statin treatment.”
— Borislava Mihaylova, DPhil
“Cardiovascular
disease remains a leading cause of disability and death. In addition to statin
treatment, people at high cardiovascular risk need further effective and
cost-effective treatments to reduce their risks. We are currently studying such
treatments — how well they work and whether they are of good value for (the)
money in categories of people, including older people,” she said.
Further evidence of the
importance of continuing statin use
MNT also spoke with Yu-Ming Ni,
MD, a board certified cardiologist and lipidologist at MemorialCare
Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley,
CA, about this study.
“This
is not really surprising,” Ni said. “We’ve known for a very long time that
statins prevent heart disease. They’re especially effective for patients who
already have heart disease to prevent a recurrent event — that means another
heart attack, stroke, or leg artery blockage. Patients benefit from these
medications by reducing their risk for events, it improves the quality of life,
and reduces symptoms from those events, and the result is that people live
longer and healthier.”
“It seems clear to me from this study it appears that
patients still get a benefit from being on a statin into their 70s. Something
that I took away from this (study) is that patients who are on statins already
with prior cardiovascular disease stand to maintain their benefit as they
continue through into their 70s. And I think that’s important because we often
ask ourselves whether we really need to take this medication as we’re getting
older and there are other competing factors, other medical admissions.”—
Yu-Ming Ni, MD
“We
know that a lot of people, as you get older, take a lot of medications. They
can get tired of taking pills, but this study helps to suggest that the benefit
from the statin persists, so those who already have heart disease should
continue to take their medication unless there’s a strong reason to stop the
statin. I generally recommend continuing taking the statin well into older
years,” Ni added.
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