Evidence for the benefits of statins in reducing risk stroke and heart disease is overwhelming, especially in “mid-life,” loosely defined as 40-65 years. Most physicians continue to prescribe them for patients over the age of 75, termed “the elderly,” but it is uncertain if the risks outweigh the benefits at this age.

A new study looked at a group of over 14,000 elderly, comprising 8% of the 187,000 (!) participants in a cholesterol treatment trial. Looking at all age groups, there was a 25% reduction in major coronary events. Stroke risk was reduced by 16%. Regardless or age, there was a 25% reduction in coronary revascularization procedures, although not overall mortality. Thus, the elderly still derived some benefit from statins.

The researchers advised that the decision should be made on a case-by-case basis. More baseline cardiovascular risk factors, common although not universal in the elderly, would likely justify continued statin therapy.

The study was published in Lancet 2019 with an editorial comment by Cheung and Lamm in that same issue.

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