University of Oxford researchers find statins 'increase quality of life' for over-70s

More elderly people should be using statins, experts have said after a new study suggested the common drugs can improve health outcomes for over-70s.

A research team, led by academics from the University of Oxford, set out to examine the benefits of statin use in older people with and without a history of heart problems.

They found the cholesterol-busting medication is a “cornerstone” in preventing heart disease.

Despite the ageing population, and the “markedly higher cardiovascular disease risk with increasing age”, there is “lower” statin use among older people, they added.

The new modelling study drew data from two long-term UK studies tracking the health of the population – the UK Biobank and the Whitehall II studies.

Using the data, they projected the number of years people can expect to live in good health – also known as quality-adjusted life years – in 5,103 people with previous cardiovascular disease and in 15,019 without.

They concluded that statin use was linked to better health outcomes in older people with or without previous cardiovascular disease.

The authors also performed a cost-benefit analysis on statin treatment.

“Our results indicate that older people are likely to cost-effectively benefit from statin treatment,” the authors wrote in the journal Heart.

“Lifetime statin treatment increased quality of life-adjusted survival in older men and women and, at UK cost of generic statins, was highly cost-effective for all,” they added.

Lead author Dr Borislava Mihaylova, associate professor and senior health economist at the University of Oxford’s Nuffield Department of Population Health, said: “Our study reports that statins are likely to increase quality of life-adjusted survival cost-effectively for both men and women aged over 70 years irrespective of whether or not they have had heart disease or stroke previously.

“It indicates that more older people should be considered for treatment.”

Commenting on the study, Tim Chico, professor of cardiovascular medicine at the University of Sheffield, said: “The most reliable way to understand whether a treatment like statins prevents heart disease is a randomised controlled trial (RCT) where people are given the drug or placebo.

“This new study takes an approach to ‘simulate’ what would happen if people over 70 were treated with statins.

“The model used for the simulation assumes the benefit of statins shown in the previous metanalysis, so this study is not itself proof of a benefit. The model does accurately simulate risk of future heart disease in older people, and it suggests that statins provide a cost-effective benefit even in older people.

“Two RCTs are ongoing to understand whether statins are as effective in older people as they are in younger people, but in the meantime the weight of evidence suggests that even people over 70 years can benefit from statins.”

The study authors added: “While further evidence for statins effects in older people will be helpful, the robustness of the findings to variations in key parameters suggests that delaying statin treatment in the millions of older people while awaiting new evidence is unjustifiable.”

Commenting on the findings, Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation, and a consultant cardiologist, said: “Statins have transformed prevention of future heart attacks and strokes.

“Numerous clinical trials over the last decades have shown strong evidence for their routine use in people at high risk of having a heart attack or stroke, or in those that have had a heart attack already, regardless of age.

“As someone ages, the risk of a heart attack or stroke happening increases, heightened by additional risk factors like high cholesterol, high blood pressure, obesity and diabetes.

“This large population study suggests that, for older people, being on a statin was linked to an increase in healthy life years and is cost effective. That’s important not least because we in the UK have an ageing population who want to live healthier for longer.

“The study is an observational modelling study so cannot determine the causes of the associations seen, and findings in the volunteers may not be representative for all. Nevertheless, it does show that there may be lifetime benefits for the over-70s at a population level.

For individuals, the decision to take a statin should be based on a discussion between patient and doctor about personal risks and benefits.”

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