Should You Start a Statin at 75? The First Real Test Just Reported

Key Points:

• The STAREE trial, the first large randomized study of statins for primary prevention in people aged 70 and older, found that atorvastatin reduced major cardiovascular events by 30% over about six years compared to placebo.
• Despite fewer heart attacks and strokes, the statin did not significantly improve disability-free survival, which includes being alive without dementia or lasting physical disability, suggesting that non-cardiovascular causes remain major threats to independence in this age group.
• Side effects such as muscle problems and diabetes-related issues were more common with statins, though serious adverse events were similar between groups; these risks are important considerations for older adults.
• Patients over 70 should discuss their individual 10-year cardiovascular risk, the potential value of coronary artery calcium scans, and possible side effects with their doctors to make an informed decision about starting statins.
• The trial provides new evidence supporting statin use for heart protection in older adults, but whether statins extend the quality of life remains uncertain, and further research like the ongoing PREVENTABLE trial is awaited.