Statins for primary prevention associated with CV benefit in older adults
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Statin use for primary prevention was associated with CV benefits in older adults, without significant risk for development of new-onset diabetes, according to research published in the American Journal of Medicine.
“The benefit of statins in the reduction of cardiovascular disease and all-cause mortality has been well demonstrated for persons with existing cardiovascular disease, for adults of all ages,” Gil Lavie, MD, MHA, MBA, from Clalit Health Services in Tel Aviv, Israel, and colleagues wrote. “Elderly people represent the fastest-growing segment of the population in Western countries. ... Consistent with the present evidence, current clinical guidelines state that the data are insufficient to determine greater benefit than risk of the use of statins for primary prevention in older adults.”
In a retrospective population-based cohort study, researchers analyzed CV outcomes among 42,767 new users of statins stratified by age (70 years or older vs. younger than 70 years). Utilizing a time-dependent approach, the researchers evaluated statin adherence levels according to proportion of days covered (< 25%, 25% to 50%, 50% to 75% and 75%).
Incident rates were as follows:
- major adverse CV events: older group, 16.9%; younger group, 6.3%;
- all-cause mortality: older group, 16.7%; younger group, 1.7%; and
- new-onset diabetes: 9.4% in both groups.
Among older patients, compared with those with the least statin adherence, those with the most adherence had reduced risk for major adverse CV events (HR = 0.71; 95% CI, 0.57-0.88) and all-cause mortality (HR = 0.69; 95% CI, 0.55-0.86) but not new-onset diabetes (HR = 1.06; 95% CI, 0.81-1.4). For younger patients, the trends were less pronounced in risk for major adverse CV events (HR = 0.8; 95% CI, 0.68-0.93) and all-cause mortality (HR = 0.77; 95% CI, 0.58-1.03), and the most adherent group had greater risk for new-onset diabetes than the least adherent group (HR = 1.2; 95% CI, 1.06-1.36), according to the researchers.
“Statin use for primary prevention among adults without diabetes was associated with cardiovascular benefit in adults aged 70 years and older, without a significant risk for the development of diabetes,” Lavie and colleagues wrote. “These data may support the use of statin therapy for primary prevention in the elderly.”
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