Statins Effective in Elderly, Too
Drug Therapy Reduces Heart Attacks at Any Age
Nov. 18, 2002 (Chicago) --There is no age limit on heart disease prevention -- from middle age to old age, the potent cholesterol-lowering drug Pravachol can reduce heart attacks and can cut the risk for fatal heart disease.
James Shepherd, PhD, head of the university department of pathological biochemistry at the Royal Infirmary in Glasgow, Scotland, who studied almost 6,000 elderly Scots, says the results suggest that Pravachol, a statin, is an equal-opportunity drug: The elderly get the same benefit as younger people.
Although known as an effective treatment for preventing heart attacks, statin treatments are currently reserved for the middle aged, says Shepherd. In recent years, several studies suggested that giving Pravachol or other statin drugs to middle-aged people can reduce the risk for heart disease and stroke -- even when people have relatively normal cholesterol levels.
In this new study, patients who took 40 mg of Pravachol every day had a 20% reduction in heart disease death and non-fatal heart attacks. A reduction in strokes was not seen in this study. Moreover, taking the statin dropped LDL "bad" cholesterol by an average of 34%, says Shepherd.
The results were presented at the American Heart Association's Scientific Sessions 2002 meeting. Augustus Grant, MD, president-elect of the AHA, says the study makes a strong case for use of statins in the elderly, which is significant since Americans over age 70 is the fastest growing segment of the population. Grant is professor of medicine at Duke University Medical Center in Durham, N.C.
Sidney C. Smith Jr., MD, chief science officer at the American Heart Association, says the study again points to the need for the use of good medical therapies with elderly patients. "We should be willing to prescribe drugs that will keep the elderly healthy and off ventilators rather than spending money on expensive end-of-life treatments," says Smith.
The average age of patients in the study was 75, which is more than 10 years older than the average age of patients in most heart disease prevention studies, says Grant. He says that based on this study and other recent studies, "I am inclined to use statins for older patients in my practice."
There were, however, two downsides to the study: Patients taking Pravachol were more likely to develop new cancers during the study than patients taking dummy pills, and Pravachol didn't protect against memory and thinking problems associated with aging.
Asked about the cancer data, Shepherd says that even though there were 199 new cancer cases in the placebo patients and 245 cancer cases in the Pravachol patients, he doesn't think Pravachol can be faulted. "It takes a long time for cancer to develop," says Shepherd, who noted that most of the cancers were diagnosed during the first year of the three-year study. So the most likely explanation is that the patients had undetected cancers before entering the study.
The researchers were particularly disappointed by the lack of effect on memory and thinking, says another study researcher, Michael B. Murphy, MD, dean of the faculty of medicine at University College in Cork, Ireland. Murphy says he and other researchers thought that statin treatment would slow "mental" aging. "But there is no effect, and we have to rely on clinical findings."