A recent study published in The Lancet Healthy Longevity suggests that approximately 1.5 million adults in the UK over the age of 75 who take statins, primarily for the prevention of cardiovascular disease, might be able to stop taking them without a significant increase in their risk of death or major cardiovascular events. The research, conducted by scientists at Bordeaux University Hospital, examined outcomes for adults who had never experienced a heart attack or stroke.
Statins are widely prescribed to manage cardiovascular disease (CVD) by reducing the liver's production of low-density lipoprotein (LDL), often referred to as 'bad' cholesterol, which can damage blood vessels. In the UK, around eight million adults are prescribed statins, with about 1.5 million falling into the over-75 age group. These medications are typically used for primary prevention, meaning they are given to individuals at risk of a first cardiovascular event, rather than to prevent subsequent ones.
The study involved 1,160 participants with an average age of 80, who were randomly assigned to either stop taking statins or continue. After three years, the study found that 7.2% of those who stopped statins died, compared to 7.9% of those who continued. Major cardiovascular events occurred in 5% of those who discontinued treatment, versus 4.4% of those who continued. Heart attacks were observed in 2.1% of those who stopped, compared to 1.4% who continued, and non-fatal strokes occurred in 14 participants who stopped versus 12 who continued. The authors concluded that these differences were not statistically significant, deeming the discontinuation of statins "noninferior" to continuing them for this specific patient group.
However, discontinuing statins led to a notable increase in LDL cholesterol levels. Participants who stopped taking the medication saw their average LDL levels rise from 115mg/dl to 171mg/dl within three months, while those who continued maintained stable levels around 112mg/dl. High LDL cholesterol is a known risk factor for narrowed arteries, reduced blood flow, and increased risk of heart disease and stroke.
Experts not involved in the study have urged caution regarding the findings. Robert Storey, a professor of cardiology at the University of Sheffield, advised that the results should not inform decisions for most people in this age group taking statins. He noted that the slight increase in heart attack risk warrants caution and emphasized that larger studies are needed to assess the impact on life expectancy. He also pointed out that the study found no detrimental effect on quality of life from continuing statin treatment.
Bryan Williams, chief scientific and medical officer at the British Heart Foundation, acknowledged the study's insights but highlighted its limitations, including the relatively small number of participants and their potentially healthy lifestyles. He stressed that the findings are not applicable to the millions of individuals with a history of heart attack, stroke, or other cardiovascular conditions, for whom statins remain life-saving. Both experts strongly advised that any decisions about changing or stopping statin medication should be made in consultation with a doctor.