Pravastatin provides no prevention benefit for seniors with hyperlipidemia

Researchers found no benefit in primary cardiovascular prevention when pravastatin was given to adults 65 years and older with moderate hyperlipidemia, according to data presented at the American Geriatrics Society Annual Meeting.

To examine statin use and multiple outcomes for adults aged 65 and older when used for primary prevention, the researchers from New York University conducted a subanalysis of the lipid-lowering trial (LLT) portion of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), an open label, randomized study, using pravastatin compared with usual care. The mean follow-up period was 4.8 years, among a subset of participants that had enrolled in ALLHAT. There were 1,458 participants in the pravastatin group, and 1,386 in the usual care group.

The researchers’ secondary analysis focused only on adults aged 65 years and older without atherosclerotic cardiovascular disease at baseline. They stratified baseline age groups into 65 to 74, 75 to 79, 75 and older and 80 and older. They also examined baseline characteristics, and compared the primary outcome of all-cause mortality and secondary outcomes outlined in ALLHAT-LLT.

The mean LDL level was 147.7 mg/dL in the pravastatin group, and 147.6 mg/dL in the group that received usual care. According to the researchers, by year 6, the LDL levels were 109.1 in the pravastatin group, and 128.8 in the usual care group. In addition, at year 4, 17% of the participants assigned to pravastatin were not on a lipid-lowering drug, compared with 79.3% among those in the usual care group. None of the specified outcomes differed significantly (P < .05).

The relative risk for all-cause mortality in the pravastatin group was 1.08 (95% CI, 0.85-1.37; P = .55) among adults aged 65 to 74 years. For adults aged 75 to 79 years, relative risk was 1.46 (95% CI, 0.96-2.24; P = .08), and among those aged 80 years and older, it was 1.2 (95% CI, 0.74-1.95; P = .46). For participants 75 years and older, there was a trend for increased mortality among those assigned to pravastatin (RR = 1.34; 95% CI, .98-1.84; P = .07). – by Jason Laday

Reference:

Sutin D, et al. Abstract P18. Presented at: 2016 American Geriatrics Society Annual Scientific Meeting; May 19-20; Long Beach, California.

Disclosure: The researchers report funding from the National Heart, Lung and Blood Institute, and the Stroke Foundation. Healio Family Medicine could not confirm additional financial disclosures.