Key News in Family Medicine February 01, 2019 (10 of 11)

The statin helps reduce major vascular events, such as heart attacks and strokes, in people of all ages, including those over 75, according to a new study published in The lancet.

The study evaluated the effects of statins in nearly 187,000 people who participated in 28 major clinical trials. Participants were divided into six age groups (under 55, 55 to 60, 60 to 65, 65 to 70, 70 to 75 and over 75) to badess the effects of statins. major vascular events (heart attacks, strokes, and coronary revascularizations), cancer incidence, and death.

Anthony Keech, professor of medicine, cardiology and epidemiology at the University of Sydney, said: "Statin therapy has been shown to prevent cardiovascular disease in a large number of people, but its effectiveness and safety are The study summarized all available evidence from major trials to help clarify this problem, and we found a significant reduction in major vascular events in each of the six age groups considered, including patients. older than 75 years at the start of treatment. "

Statins help lower blood cholesterol levels in low density lipoproteins (LDL) and are prescribed to millions of people around the world. High LDL cholesterol can lead to hardening and narrowing of the arteries and cardiovascular disease. The researchers found that, overall, statin therapy reduced the risk of a major vascular event by about a quarter for every millimole reduction per liter of LDL cholesterol, even in the elderly. In addition, the new study showed that statin therapy did not increase the risk of death from non-cardiovascular disease or cancer risk, regardless of age.

Cardiovascular risk reductions were observed, regardless of age, in individuals with or without known vascular disease at the beginning of the trials. There was less evidence for people over 75 years of age who did not already have signs of vascular disease (those who had been prescribed statin therapy for "primary prevention" of heart attacks and strokes). New randomized trials are now investigating the effects of statins in apparently healthy older people.

Dr. Jordan Fulcher, co-investigator at the University of Sydney, explains, "Statin therapy seems to be just as effective for people over 75 as it is for younger people." There is conclusive evidence that statins are beneficial for the elderly who have suffered, fewer healthy seniors have been represented in these trials, so more information about this group of people would help confirm the same benefits as the overall our clinical trials.A new randomized trial in Australia, called STAREE1, is specifically exploring whether statin therapy can extend disability-free survival in a healthy elderly population. "

The co-investigator, Professor Colin Baigent, director of the Population Health Research Unit of the Oxford University Medical Research Council, added: "The risk of seizures Cardiac and stroke increases significantly with age, but statins are not used as widely in the elderly.As the risk of heart attack and stroke increases with At age, the potential benefits will probably be even greater for older people. "

"Therefore, it is necessary to ensure that patients at risk of cardiovascular disease because of their age benefit from statin therapy when there is good reason to believe that it will be beneficial. wonders if statin therapy is appropriate for them should discuss this with their GP. "

The study was conducted by the Collaboration for Clinical Trials on Cholesterol Therapy (CTT), a joint initiative of the Clinical Trials Center of the National Board of Health and Medical Research (NHMRC) of the University of Sydney, Australia, and the Department of Clinical Trials and Epidemiology (CTSU), Department of Population Health, Nuffield, University of Oxford, on behalf of university researchers representing important trials of statins worldwide . The work was funded by the UK Medical Research Council (MRC), the Australian National Board of Health and Medical Research (NHMRC) and the British Heart Foundation (BHF).

The full document, "Efficacy and safety of statin therapy in the elderly: a meta-badysis of individual participant data from 28 randomized controlled trials", can be read in The lancet.