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Statin use increasingly common among very elderly patients
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From 1999 to 2012, statin use among patients aged over 79 years was increasingly common, despite a lack of data from randomized trials supporting their use in this patient population, according to results published in JAMA Internal Medicine.
The researchers used data from the 1999-2012 Medical Expenditure Panel Survey to evaluate statin use for primary or secondary prevention among 13,099 patients aged older than 79 years with no liver disease. Atorvastatin and rosuvastatin were identified as high-potency statins.
“There is little randomized evidence to guide the use of statins in very elderly individuals,” the researchers wrote. “Despite this, the very elderly have the highest rate of statin use in the United States.”
The prevalence of vascular disease increased over time, from 27.6% of patients in 1999-2000 to 43.7% in 2011-2012. Statin use for primary and secondary prevention increased significantly over the same time period (P < .001 for both). For primary prevention the rate of statin use, increased from 8.8% in 1999-2000 to 34.1% in 2011-2012.
Use of atorvastatin peaked in 2005-2006 and then declined steadily. Rates of simvastatin use remained consistent until 2007-2008, then began to rise. Rosuvastatin use increased consistently after its introduction in 2003.
“One-third of community-dwelling very elderly individuals without vascular disease reported a statin prescription despite a lack of randomized clinical trials to support their use,” the researchers wrote. “Although the medical community has embraced the use of statins for primary prevention in the very elderly, caution should be exercised given the potential dangers of expanding marginally effective treatments to untested populations.” – by Adam Taliercio
Disclosure: The researchers report no relevant financial disclosures.
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