Benefits of statins in elderly subjects without established cardiovascular disease. a meta-analysis

Statin Therapy as Primary Prevention in Exercising Adults: Best Evidence for Avoiding Myalgia

“…91 A benefit against mortality for women alone has been shown, 89 but this is not a uniform finding. 86,88 There is limited evidence that statins can reduce CVD events in elderly patients, 6 but there is no benefit against mortality, and overall treatment in this age group remains controversial. Several meta-analyses provide evidence that high-dose statin therapy, as opposed to moderate doses, provides additional protection against cardiovascular events, but not all-cause mortality, in secondary prevention, 85,92,93 but no such benefit has been found in primary prevention.…”

“…4 Several meta-analyses have suggested event reduction beyond age 75. [5][6][7] Relative event reduction is thought to be at least as large in patients at low risk for CVD as it is for those at high risk, admittedly with much larger numbers needed to treat. Although individuals without known CVD are at lower absolute risk, nearly half of vascular events may occur in this population.…”

Should Patients Continue to Receive Statins Once They Reach 80 Years of Age?

“…However, despite their perceived negative reputation, statins are conspicuously absent from the American Geriatric Society's 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. 1 That list does include other ubiquitous drugs, such as ␣ 1 blockers, ␣ 2 agonists, amiodarone, and digoxin, but we are not debating the appropriateness of using these drugs in older patients. Is that because we are so enlightened in practice that we no longer use these agents in older patients (a proposition that I would fervently dispute), or do statins suffer ill repute for some reason when it comes to persons of advanced age?…”

“…A recent systematic review of statin trials for primary prevention in older patients found that the average age of participants was 73 years. 1 Similarly, a systematic review of statin trials for secondary prevention in older patients found that the average was 69 years. 2 As such, patients over 80 years of age represent only a small subgroup of all patients enrolled in the trials, which leaves uncertainty about the treatment effect of statins in this older age group.…”

Efficacy and Safety of Lipid-Lowering Drugs in Primary and Secondary Prevention of Cardiovascular Diseases in the Elderly

“…Согласно результатам мета-анализа 8 РКИ (n=24674; средний возраст 73,0±2,9 лет; пе-риод наблюдения 3,5±1,5 года), статины значитель-но снижают частоту ИМ и инсульта у пожилых людей с высоким риском развития ССЗ, но существенно не удлиняют продолжительность жизни в краткосрочной перспективе [69]. В другом мета-анализе 8 РКИ (25952 лиц ≥65 лет) статины значительно снижали комбини-рованную конечную точку, включавшую большие не-желательные сердечно-сосудистые события, нефа-тальный ИМ и ИМ в целом, однако эффект статинов в отношении фатального ИМ, инсульта (фатального и не-фатального) и общей смертности оказался статистически недостоверным [70].…”