Statin Cessation Increases Cardiovascular Risk in Elderly

The discontinuation of statin therapy in healthy individuals 75 years of age and older was associated with an increased risk for developing cardiovascular disease.

The new study, published in the European Heart Journal, was a survey of 120,173 individuals in France aged 75 or older with no history of cardiovascular disease. The participants had been taking statins for two years prior. The authors defined statin discontinuation as three consecutive months without exposure, and the primary study outcome was hospital admission for a cardiovascular event. The researchers estimated the hazard ratios of statin continuation versus discontinuation with a marginal structural model. Subjects were followed for an average of 2.4 years.

According to the results, 17,204 (14.3%) of subjects discontinued statins and 5,396 were admitted for cardiovascular events. Adjusted hazard ratios for statin discontinuation were 1.33 (95% CI, 1.18 to 1.50) for any cardiovascular event, 1.46 (95% CI, 1.21 to 1.75) for coronary events, 1.26 (95% CI, 1.05 to 1.51) for a cerebrovascular event, and 1.02 (95% CI, 0.74 to 1.40) for other vascular events.

“To patients, we would say that if you are regularly take statins for high cholesterol, we would recommend you don’t stop the treatment when you are 75. To doctors, we would recommend not stopping statin treatment given for primary prevention of cardiovascular diseases in your patients aged 75,” Dr. Philippe Giral, an endocrinologist specialist in prevention of cardiovascular disease at Pitié-Salpêtrière Hospital in Paris, said in a press release.

Co-author of the study, Professor Joël Coste, an epidemiologist at Cochin Hospital added in a press release that “while we wait for results from randomized controlled trials, carefully conducted observational studies such as this can provide useful information for doctors and patients, and can contribute to establishing more precise guidelines on the use of statins for primary prevention in the elderly.”