Increased risk of cardiovascular disease among healthy 75-year-olds who stop taking statins

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<div data-thumb = "https://3c1703fe8d.site.internapcdn.net/newman/csz/news/tmb/2019/1-increasedris.jpg" data-src = "https: //3c1703fe8d.site.internapcdn. net / newman / gfx / news / 2019/1-higherris.jpg "data-sub-html =" Study design and main result show increased risk of CVD for healthy 75-year-olds who stop taking statins as a preventive measure. European Heart Journal">

Statins are known to reduce the risk of additional problems in patients of any age who have already suffered from heart problems or stroke. However, until now, the effectiveness of their use in preventing such events in healthy people aged 75 and over, with no history of cardiovascular disease, has not been clearly established.

Now, a national study conducted in France on 120,173 people aged 75 years between 2012 and 2014 and taking statins continuously for two years revealed that people who stopped taking their statins had 33% more risks than men. To be hospitalized with hospital. or blood vessel problems during an average follow-up period of 2.4 years.

The study, published in the journal European Heart Journal is now the first to evaluate the impact of stopping statins in primary prevention in the elderly. Dr. Philippe Giral, an endocrinologist specializing in the prevention of cardiovascular diseases at the Pitié-Salpêtrière hospital (part of the Assistance Publique-Hôpitaux de Paris), in Paris, France, led the research and stated that although new randomized studies are needed before recommendations can be developed. updated, he advises older people taking statins to prevent cardiovascular disease from continuing to take 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.

Researchers badyzed data from the French health insurance claims database and information on hospital diagnoses and clinical procedures. They were able to obtain complete information on the use of statins, especially since statins are only available on prescription for the entire French population. 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 people with cardiovascular fitness in the badysis. They excluded anyone who had been diagnosed with cardiovascular disease and anyone taking other medications to treat or prevent heart problems or blood vessels.

The researchers followed 120,173 patients for up to four years (an average of 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. Giral said, "We estimated that an additional 2.5 cardiovascular events per 100 people would occur within four years in those who stopped the administration of their statins at age 75 years compared to those who continued to take their statins. "

The researchers point out that it's an observational, retrospective and non-randomized study and therefore can not show that stopping statins can cause a heart attack or stroke, but only that he is badociated with it. However, they claim that a lot of patient health information has been used to improve their badociation estimates and that their results correspond to the known relationship between cholesterol levels and cardiovascular risk.

Professor Joël Coste, an epidemiologist at the Cochin hospital (also a member of the Assistance Publique-Hôpitaux de Paris), co-author of the study, said: "If we wait for the results of randomized controlled trials, studies Carefully conducted observational observations of this type may provide useful information for physicians and patients, and may contribute to the establishment of more specific guidelines on the use of statins in primary prevention in the elderly. "

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 older, and the entire 75-year-old French population, including the participants in this study, had: a similar rate of non-compliance among users of statins: 44% had not taken statins for at least 80% of the time at least one of the two previous years.

People discontinue statin therapy for a number of reasons, not all of which are known. In this study, researchers identified reasons such as other health problems, cancer, hospital admission or changes in daily care (such as admission to hospital). in a retirement home, problems with food). Adverse effects can also be a reason why people might stop taking statins.

The limitations of the study include the fact that the use of statins was defined by the orders issued, although the researchers pointed out that since patients were prescribed prescriptions regularly, they would not be likely to take not the drug; researchers did not have information on the socio-economic status of patients, their lifestyle, their cholesterol levels at the beginning of the period studied, smoking, obesity and the fragility; and they did not have specific information about why people stopped taking statins.