Heart disease can come with age despite a heart-healthy youth. Statin drugs are the most effective and most prescribed drugs for high cholesterol and for the prevention of a second stroke or heart attack. These benefits are well supported by clinical studies. But can statins benefit older adults who have no history of high cholesterol, heart attack, or stroke? A new study from researchers at Brigham and Women’s Hospital and the Mass General Brigham health-care system finds that statins are both safe and effective for these adults, even if they are considered frail.

The new study is published in the Journal of the American Geriatrics Society. The research team notes that statins have few side effects and are well tolerated by the vast majority of people taking them. However, one of the questions about using statins to reduce the risk of heart attack or stroke in elderly individuals without a previous history of heart conditions is that older people who are frail might be at higher risk from statin side effects or receive less benefit.

To find out, the research team analyzed data from over 700,000 people age 65 or older in the Veterans Affairs (VA) Health Care System. Veterans were included in the study with or without frailty who had no prior history of a cardiovascular event such as stroke or heart attack. The data was analyzed starting in 2002 and followed through 2017.

Do Statins Deter Death?

To diagnose frailty, the veterans were tested with a 31-item frailty index. The key outcome was how many veterans would die during the study period from any cause and how many would have a cardiovascular event (stroke, heart attack, or cardiovascular-related death), and compare these outcomes between those who were frail, not frail, taking statins, or not taking statins. These were the key findings…

  • The veterans who were taking a statin had a 39 percent lower risk of death from any cause during the study compared with those not taking a statin, and a 14 percent lower risk of a first cardiovascular event.
  • Non-frail vets taking statins were less likely to die during the study period or experience cardiovascular events than non-frail vets not taking statins.
  • Frail vets taking statins had fewer deaths and cardiovascular events than frail vets not taking statins.

A Criteria for Frailty

Frailty is usually thought of as weakness that comes with age, but recent research suggests that frailty is also a condition of aging that can be diagnosed with certain criteria, called the frailty syndrome. This syndrome includes age-related loss of muscle, stamina, and strength, and may include two or more chronic diseases, such as diabetes or arthritis. Using these diagnostic guidelines, it is estimated that seven to 12 percent of people over age 65 meet the frailty criteria.

The researchers conclude that statins should be considered as an option for older adults at risk for a first heart attack or stroke based on the current research. Statins appear to be safe and effective for older adults with or without frailty.

Source: Study titled “New Statin Use, Mortality, and First Cardiovascular Events in Older US Veterans by Frailty Status,” led by researchers at Brigham and Women’s Hospital, Boston, published in Journal of the American Geriatrics Society.

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