Statins benefit older people

November 21, 2002

Elderly people at high risk of cardiovascular disease could benefit substantially by treatment with statins, cholesterol-lowering drugs with known effectiveness among middle-aged people at risk of heart disease and stroke, conclude authors of a study in this week's issue of THE LANCET.

James Shepherd from the University of Glasgow, UK, and colleagues assessed the benefits of pravastatin treatment in around 6000 men and women aged between 70 and 82 years with--or at high risk of developing--cardiovascular disease and stroke. Half the study population were given 40 mg/day pravastatin, the other half a placebo, with an average follow-up of just over three years.

Pravastatin lowered LDL ('bad') cholesterol concentrations by a third, and reduced a combination of coronary death, non-fatal heart attack, and fatal or non-fatal stroke by 15%; this amounted to an absolute risk reduction of around 2%. Pravastatin was most effective in reducing death from heart disease (nearly a 25% relative risk reduction) whereas stroke risk was unaffected.

In an accompanying Commentary (p 1618), Rory Collins and Jane Armitage from the Clinical Trial Service Unit & Epidemiological Studies Unit, Radcliffe Infirmary, Oxford, UK, conclude: "...PROSPER and the other large-scale trials have now collectively shown that cholesterol-lowering statin therapy rapidly reduces the risks of major vascular events not only in middle age but also in older age, and the benefits are substantial among patients who are at high risk because of pre-existing occlusive arterial disease, diabetes, or other factors (including age). These studies have also shown that such treatment is well-tolerated and safe, even among older patients, with no good evidence of any increase in cancer or other non-vascular morbidity or mortality. Hence, long-term statin therapy should now be considered routinely for all such high-risk patients largely irrespective of either their presenting lipid concentrations or their age."
-end-
Contact: Professor J Shepherd, University Department of Pathological Biochemistry, Royal Infirmary, Glasgow G4 0SF, Scotland, UK;
T) 44-141-552-0689;
F) 44-141-553-1703;
E) jshepherd@gri-biochem.org.uk

Professor Rory Collins, Clinical Trial Service Unit & Epidemiological Studies Unit,
Harkness Building, Radcliffe Infirmary,
Oxford OX2 6HE, UK;
E) secretary@ctsu.ox.ac.uk

Lancet

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