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Study: Stopping Statins in the Elderly May Be Risky

Statin

June 23, 2021 -- Cutting down on the number of prescriptions may help in reducing drug reactions and hospitalizations, but in elderly patients with heart problems, eliminating cholesterol-lowering statins could far outweigh the benefits.

In a large study, researchers report that withdrawal of statins from elderly people receiving a variety of other drugs was linked to a higher risk of hospital admission for heart failure and any cardiovascular outcome, as well as death from any cause.

Statins are "life-saving" drugs and, according to the findings of the study, “the discontinuation of this therapy has significant effects,” says lead study author Federico Rea, PhD, a research fellow in the Department of Statistics and Quantitative Methods at the University of Milano-Bicocca in Italy.

The research, published online June 14 in JAMA Network Open, examined almost 30,000 patients 65 years of age and older on multiple medications, often referred to as "polypharmacy," who were receiving treatment with statins, as well as blood pressure-lowering, antidiabetic, and antiplatelet agents.

Discontinuing statins was associated with a significantly increased risk of hospital admission for heart failure of about 24%, other cardiovascular outcomes by 14%, and death from any cause by 15%.

Study investigators say more attention is needed by all health care providers caring for elderly patients. “We hope that future studies can shed light on the best way to balance the undeniable benefit of [statins] and the harms, especially among the elderly exposed to polypharmacy,” says Rea.

Neil Stone, MD, a professor of medicine and preventive medicine at Northwestern University's Feinberg School of Medicine, says the study results aren't surprising.

"Older patients have a higher absolute risk of dying, and withdrawing proven therapy shown to reduce risk of coronary/stroke events in randomized controlled trials would be expected to result in more cardiovascular events," he says.

While polypharmacy is a concern in the elderly, he says there are better solutions needed than withdrawing proven, effective therapy.

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Sources

JAMA Network Open: “Cardiovascular Outcomes and Mortality Associated With Discontinuing Statins in Older Patients Receiving Polypharmacy.”

Federico Rea, PhD, research fellow, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Italy. 

Neil Stone, MD, Bonow professor of medicine (cardiology) and preventive medicine, Feinberg School of Medicine, Northwestern University.

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