Statins are a type of medication that can help lower a person’s “bad” cholesterol, reducing their risk for cardiovascular disease. Adults between the ages of 40 and 75 who have heart disease risk factors are generally recommended to take statins. However, fewer older adults use statins despite having higher risks for cardiovascular disease. Researchers from the University of Oxford found that statin treatment was both cost-effective and correlated with better health outcomes in older adults with or without previous cardiovascular disease. The U.S. Preventive Services Task Force recommends adults between the ages of 40 to 75 who have one or more cardiovascular risk factors and an estimated 10-year cardiovascular disease risk to take statins to help prevent heart issues.
Despite the high risks of heart disease and stroke in older people, fewer older adults use statins compared to middle-aged people. This may be due to fewer older individuals contributing to randomized studies of statin therapy, leading to more limited evidence with larger uncertainty. To address this gap in knowledge, researchers at the University of Oxford re-examined the value of statin therapy for older adults using the latest evidence and contemporary population data. They found that statin treatment was both cost-effective and correlated to better health outcomes in older adults with or without previous cardiovascular disease. By analyzing data from the U.K. Biobank and Whitehall II study, the researchers estimated the heart disease risk, survival rate, quality-adjusted life years, and healthcare costs of participants with and without standard or higher intensity statin therapy.
Standard statin therapy normally results in a 35-45% reduction in LDL cholesterol, while higher-intensity treatment can lower LDL cholesterol by 45% or more. Participants who stayed on standard statin treatment for their lifetime increased their quality-adjusted life years by 0.24-0.70, and those on higher-intensity statin therapy raised their quality-adjusted life years by another 0.04-0.13. Cost-effectiveness analysis showed that statins were cost-effective in older adults, with the cost per quality-adjusted life years gained well below the threshold for good value interventions, indicating that statin treatment could be of good value-for-money across people over 70 years old.
Cardiovascular disease remains a leading cause of disability and death, and effective and cost-effective treatments are needed to reduce risks for those at high cardiovascular risk. Further studies are being conducted to evaluate the effectiveness and cost-effectiveness of additional treatments for people at high cardiovascular risk, including older individuals. Cardiologist and lipidologist Dr. Yu-Ming Ni emphasized the importance of continued statin use in older adults, as the benefits of these medications persist into their 70s. Patients with prior cardiovascular disease can maintain the benefits of statin therapy as they age, improving their quality of life, reducing symptoms from events, and potentially leading to longer and healthier lives. Dr. Ni recommends that patients continue taking statins well into older age, unless there is a strong reason to stop the medication.
