- Although statins reduce risk for major vascular events in people over age 75 years, in the absence of occlusive vascular disease, evidence is “less direct.”
- Authors of this meta-analysis say current trials are addressing this gap.
Why this matters
- Authors say the findings suggest that 1.0 mmol/L reduction in low-density lipoprotein (LDL) cholesterol could translate into annually preventing major vascular events in:
- 50 of every 10,000 people aged 63 years and
- 80 of every 10,000 people aged 78 years.
- For the overall population across studies, risk reduction was 21% with statin therapy:
- Rate ratio, 0.79 (95% CI, 0.77-0.81).
- Reductions were seen across all age groups but diminished with age.
- Statin or therapy intensification was linked to 24% risk reduction for major coronary events for each 1.0 mmol/L reduction in LDL.
- With age, this effect decreased (Ptrend=.009).
- A similar pattern was seen for coronary revascularization risk.
- Statins did not affect risk for nonvascular or cancer mortality or cancer incidence.
- Meta-analysis, 28 trials (n=186,854).
- Outcomes: effects on risk for major vascular events, mortality, cancer.
- Funding: Australian National Health and Medical Research Council, others.
- Those of included trials; limited direct evidence for oldest age group.