Stopping Statins in Adults Over 75 Shows Non-Inferiority in Mortality, Study Suggests

Stopping statin treatment in patients aged 75 and older shows non-inferiority regarding mortality compared to continuing the medication, according to a study published in The Lancet Healthy Longevity and reported by NotiAmérica. Researchers from the University of Bordeaux and the University Hospital Center of Bordeaux found no significant difference in all-cause mortality over a 36-month tracking period, though the discontinuation did not improve participants’ reported quality of life.

Study Design and Patient Outcomes

The investigation examined the efficacy of statins in preventing atherosclerotic cardiovascular disease among individuals aged 75 or older without a prior history of the condition. To qualify, participants had been prescribed a statin for at least one year and were capable of giving informed consent. Out of the total cohort, 639 individuals were assigned to continue their statin regimen, while 521 individuals were assigned to discontinue treatment.

During the 36-month follow-up period, 48 out of 604 participants in the continuation group passed away, representing 7.9 percent of that cohort. In the discontinuation group, 35 out of 484 participants died, amounting to 7.2 percent. According to the research findings, the absolute difference in all-cause mortality between the two groups was -0.68 percent. Because the upper limit of the group difference stayed below the pre-specified non-inferiority margin of five percent, investigators concluded that stopping statins was non-inferior to continuing them over three years.

Adverse events occurred at similar rates across both arms of the study. Adverse events were recorded in 461 out of 631 participants in the continuation group, or 73.1 percent, compared to 390 out of 527 participants in the discontinuation group, or 74.0 percent. Non-cardiovascular adverse events affected 456 participants in the continuation group and 383 participants in the discontinuation group.

Expert Cautions and Limitations

Independent experts have raised questions regarding the design and scope of the Bordeaux study. Robert Storey, professor of cardiology at the University of Sheffield in the United Kingdom, warned in comments provided to Science Media Centre UK that the research features numerous limitations and should not dictate treatment choices for the majority of older adults. He noted that the investigation was too small and the follow-up period too brief to definitively clarify the long-term benefits of statins in this demographic.

Storey also pointed out that statins typically exert a larger influence on myocardial infarction risk than on overall mortality. In the study, a heart attack occurred in 1.4 percent of those who kept taking statins, compared to 2.1 percent of those who stopped. Although the sample size was too small to establish precise risk estimates for heart attacks, Storey stated that the figures suggest caution before halting medication.

Furthermore, Storey noted that more than half of the participants over 75 were actually older than 80, placing them at an elevated baseline risk of dying from non-cardiovascular causes. The study authors and external reviewers both emphasized that continuing statin therapy showed no evidence of harmful effects. Researchers also noted recruitment challenges during the trial, as many prospective participants declined to join because they objected to the prospect of stopping their medication.