Age Alone Not A Reason to Withhold Statins in Older Adults

MedicalResearch.com Interview with:


Dr. Orkaby

Ariela Orkaby, MD, MPH
Geriatrics & Preventive Cardiology
Associate Epidemiologist
Division of Aging, Brigham and Women’s Hospital
Assistant Professor of Medicine, Harvard Medical School

MedicalResearch.com: What is the background for this study?

Response: Statins are cholesterol lowering medications that have been proven to prevent heart attacks, strokes and death in middle-aged adults. Current guidelines for cholesterol lowering therapy are uncertain as to treatment for older adults due to a lack of available data, even though older adults are at the highest risk of heart disease and death.

MedicalResearch.com: What are the main findings?

Response: Using data from the U.S. Veterans Health Administration Services and Centers for Medicare & Medicaid Services we examined the role of statins in adults aged 75 and older who have not yet experienced a heart attack, stroke or other cardiovascular event. In this retrospective analysis, we found that the risk of dying from any cause was lower by 25 percent among veterans who were newly prescribed a statins compared to those who were not treated with statins. The risk of dying from a cardiovascular event, such as a heart attack or stroke, was lower by 20 percent. Our results held even in those over age 90 and in those with dementia.

Secondarily the risk of an overall cardiovascular event, including heart attacks, strokes, coronary bypass surgery or cardiac catheterization, was 8% lower in those prescribed a statin compared to those who were not prescribed a statin.

Additionally, nearly 30,000 Veterans in this cohort were Black or African American. The risk of stroke in Blacks who were taking a statin was 15% lower compared to those not taking a statin, while in Whites there was no difference between those taking a statin and not.

MedicalResearch.com: What should readers take away from your report?

Response: This study provides evidence that statins may prevent death and cardiovascular events in adults aged 75 and over. Based on these data, age alone should not be a reason to withhold statins from older adults.

In addition, understanding the role of statins in different populations is particularly important to individualize care, and our finding in Blacks should be confirmed in other studies.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: This is a retrospective analysis using real world data with compelling results. Randomized controlled trials are needed to further understand the role of statins in prevention of cardiovascular disease and death in older adults.

MedicalResearch.com: Is there anything else you would like to add?

Response: The study focused only on veterans, a predominantly white and male population, which may limit its generalizability, but the study’s size made it possible to glean statistically meaningful information on underrepresented groups.

This research was supported by the VA (CSR&D CDA-2 award IK2-CX001800), National Institute on Aging (R03-AG060169), and VA Merit Award I01 CX001025. Support for

VA/Centers for Medicare & Medicaid Services data is provided by the Department of Veterans Affairs, VA Health Services Research and Development Service, VA Information Resource Center (project numbers SDR 02-237 and 98-004). Co-author Luc Djousse, MD, ScD, reported receiving grants from Merck. 


Orkaby AR, et al “Association of statin use with all-cause and cardiovascular mortality in US veterans 75 years and older” JAMA 2020; DOI: 10.1001/jama.2020.7848.




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Last Updated on July 8, 2020 by Marie Benz MD FAAD