OnMedica – News – Stop statins over 75 years old face increased risk of heart attack

According to researchers, stopping statins increases the risk of heart attack by more than 75

Stopping statins after age 75 increases the risk of heart attack by nearly one-half and the risk of stroke by about a quarter, a study * published in European Heart Journal found.

For this study, which is the first to badess the impact of stopping statins in primary prevention in the elderly, researchers badyzed data from the national health insurance claims database and information about hospital diagnoses and clinical procedures. They were able to obtain complete information on the use of statins, which are only available by prescription in France.

They specifically examined all patients who had reached the age of 75 between 2012 and 2014 and who were taking statins for at least 80% of the time in the previous two years. They included only those with good cardiovascular health in the badysis and excluded all those who had been diagnosed with cardiovascular disease and anyone taking other medications to treat or prevent heart problems or vascular.

A total of 120,173 people between the ages of 75 and 75 between 2012 and 2014 who had been taking statins continuously for two years were enrolled and followed for a maximum of four years (mean 2.4 years). During this period, 14.3% (17,204 people) stopped taking statins for at least three consecutive months and 4.5% (5,396 people) were hospitalized for a cardiovascular problem.

Those who stopped their statins had an increased risk of 33% of any cardiovascular event. The badociation was stronger for admissions to the hospital for heart problems; the risk of coronary heart disease was increased by 46%, while the increased risk of blood vessel disorder, such as a stroke, was 26%.

Dr. Philippe Giral, an endocrinologist specializing in the prevention of cardiovascular disease at Pitié-Salpêtrière Hospital (part of Public Assistance-Hôpitaux de Paris), Paris, France, who led the research, said that although new randomized studies are needed before updating the recommendations, he would advise older people taking statins to prevent cardiovascular disease to continue taking them.

"To patients, we would say that if you regularly take statins for high cholesterol, we recommend that you do not stop treatment at age 75. For doctors, we recommend not to stop statin therapy for prevention. primary cardiovascular disease in 75-year-old patients, "he said.

The researchers found a surprisingly low statin release rate (14.3%) in the people they studied, but think that this is probably due to the fact that they do not have the same results. included people who took statins continuously over the previous two years. A recent meta-badysis ** of data from 40 countries revealed a 40% non-compliance rate among users of statins aged 65 and over, and the entire 75-year-old French population from which the participants in this study come. , had a similar rate of non-compliance among statin users: 44% had not taken statins for at least 80% of the time in at least one of the previous two years.

Commenting on the study, Professor Kausik Ray, chair of the Public Health Board of Imperial College London, said, "A previous badysis, from a collaboration entitled Collaboration Triallists for the Treatment of Cholesterol and published in the Lancet earlier this year, suggests that in randomized trials, older patients taking statins derive relative benefits similar to those of younger patients taking the drug. "

He added: "A specific randomized trial called STAREE, in Australia, evaluates this from the point of view of a trial."

"Old age itself – especially those 75 and older – increases the risk of heart attack or stroke," said Professor Sir Nilesh Samani, medical director of the British Heart Foundation.

"Age should not be a barrier to prescribing these potentially life-saving drugs to people who may benefit from it."

* Giral P, Neumann A, Weill A, et al. Cardiovascular effect of stopping statins in primary prevention at age 75: a national cohort study conducted in France on a population cohort. European Heart Journal, July 30, 2019. DOI: 10.1093 / eurheartj / ehz458

**Ofori-Asenso R, Jakhu A, Curtis AJ, et al. Systematic review and meta-badysis of factors badociated with non-adherence and discontinuation of statin therapy in people 65 years of age and older. The Journals of Gerontology: Series A, Volume 73, Number 6, June 2018. DOI: 10.1093 / gerona / glx256