The absence of convincing evidence makes it easy to
doubt the drugs' benefit in older adults, a UW
medicine cardiovascular specialist says.
The New York Times recently addressed the topic of
people over age 75 taking statins for the prevention
of heart disease.
Statins, drugs that lower cholesterol, are clearly
for the tens of millions of Americans who have had a
heart attack, stroke or heart disease, or vessel
blockage, regardless of age.
Guidelines issued in 2013 by the American Heart
Association also recommend statins for the general
population up to age 75 – people in good health with
no history of cardiovascular disease – for the
purpose of preventing first heart attacks or
strokes.
But does taking statins make sense for people older
than 75?
Probably not for someone with a life-limiting
illness, said Dr. Bruce Psaty, a UW Medicine
internist and epidemiologist who specializes in
cardiovascular health.
“The purpose of taking statins is prevention of
cardiovascular disease, and the horizon here is
thought of in terms of 5 to 10 years,” he said.
“We have lots of evidence of benefit in middle-aged
adults (at normal risk) – tens of thousands of
patients evaluated in randomized trials.
The data are much less rich in older adults, and the
absence of convincing evidence makes it easy to
doubt the benefit in older adults.”
Statins make sense for adults of any age who already
have heart disease, who have suffered a heart attack
or stroke, or who have had arteries unblocked with a
procedure like stenting. This is called secondary
prevention.
Nevertheless, Dr. Bruce Psaty said he’d be happy to
prescribe a statin preventatively for someone who is
75 or older, otherwise healthy and who has a
reasonable life expectancy – “if that is their
wish.”
Preventive therapies are a patient’s choice, Psaty
emphasized.
Some patients don’t want to commit to taking
medications long-term or are concerned about side
effects.
Others are so concerned to avoid heart attacks or
strokes that they are eager to take preventive
therapies.
What’s not debatable is that while statins do
effectively lower cholesterol in older people, their
advantages and disadvantages add up differently than
at younger ages.
A fairly common side effect, for instance, is
myalgia, muscle aches sometimes combined with
fatigue.
Dr. Orkaby estimates that up to 30 percent of statin
takers experience this symptom, but myalgia reverses
when people stop taking statins.
Older adults who have been taking statins as a
preventive measure, or whose primary caregiver
presents the drugs for consideration, might find
value in discussing statins’ health risks and
benefits with their physician.
See also
Study finds link between commonly prescribed statin
and memory impairment (2013-10-17)
Link...
Questioned the New Guideline for Management of Blood
Cholesterol (2013-12-18)
Link...
Cholesterol impairment contributes to neuroserpin
aggregation (2017-03-19)
Link...
Cholesterol-lowering statin drugs can reduce the
risk of stroke, but sometimes should be avoided
(25/08/2011)
Link...
Gut bacteria may affect whether a statin drug lowers
cholesterol (13/03/2012)
Link...
For more information
University of Washington Health Sciences
UW Medicine
Link...
The New YorK Times
You’re Over 75, and You’re Healthy. Why Are You
Taking a Statin?
Link...
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