While there is evidence to support older adults taking statins for secondary prevention of cardiovascular disease — such as to prevent a second heart attack or stroke — there is limited evidence on the risks and benefits of this age group taking the cholesterol-lowering medication to prevent a first cardiovascular event. Now, an analysis of data from a clinical trial that compares it with usual care finds no benefit in use of a statin for primary prevention in older adults with high blood pressure and moderately high cholesterol.
The data was analyzed on a subgroup of older adults who took part in a randomized clinical trial called the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial – Lipid-Lowering Trial (ALLHAT-LLT). The researchers analyzed results on a subgroup of 2,867 participants age 65 and older with high blood pressure and no evidence of plaque buildup in their arteries (a hallmark of atherosclerotic cardiovascular disease) at baseline. The study participants were randomly assigned to receive one of two cholesterol-lowering treatments. Of these, 1,467 were assigned 40 milligrams per day of pravastatin sodium treatment, and the other 1,400 were assigned the usual care from their doctors. The analysis found no significant differences between the two groups in three types of result: deaths due to all causes, deaths to specific causes, and coronary heart disease (CHD) events. Among participants ages 65 to 74, there were more deaths in the pravastatin group (141) than in the usual care group (130). This was also the case in those age 75 and older (92 and 65 deaths, respectively).– JAMA Intern Med. 2017 May 22. doi: 10.1001/jamainternmed.2017.1442. [Epub ahead of print]