The People's Perspective on Medicine

Statins Fail to Help Healthy Older People

A study in older Spanish people found that statins fail to prevent heart attacks and strokes in people over 75 unless they have type 2 diabetes.
Statins cholesterol statin drugs

Statin drugs that lower cholesterol are among the most important tools cardiologists have for preventing heart disease among middle-aged patients. Until recently, however, no one knew whether drugs such as atorvastatin or simvastatin would benefit healthy older adults. A study published in The BMJ suggests that statins fail to protect these older individuals from cardiovascular complications.

How Did Scientists Find That Statins Fail in Preventing Heart Attacks for Seniors?

Investigators examined more than five years of health records for nearly 47,000 older people (The BMJ, Sept. 5, 2018). These individuals were at least 75 years old, did not have atherosclerosis and were not taking statins when the study began. Previous studies have shown that statins can help prevent repeat heart attacks in older adults. However, the researchers were specifically interested in primary prevention. In other words, can these drugs ward off an initial heart attack or stroke, especially in very old people?

They looked at people who started taking statins during the study period. To help with the analysis, they divided people into two categories: those with type 2 diabetes and those without. Nearly 8,000 of the people in the study had type 2 diabetes. During the study time frame, 7,500 of these older patients (both with and without diabetes) started taking a prescribed statin drug. Did it reduce their risk of heart problems?

Statins Fail at Reducing the Risk of Cardiovascular Disease:

The Spanish scientists report that there was no reduction in atherosclerotic heart disease or death rate among seniors taking statins. The exception was for those who had diabetes. Older people with diabetes were less likely to develop heart disease or die if they were taking a statin. That benefit held for the decade between 75 and 85 years old.

The authors conclude:

“These results do not support the widespread use of statins in old and very old populations, but they do support treatment in those with diabetes who are younger than 85 years.”

Once people with diabetes reached 85, any benefit from statins diminished and it disappeared completely in nonagenarians.

This is not the first study to show that statins fail to benefit very old individuals. An analysis published four years ago in JAMA showed that there was no good evidence supporting statin use in healthy seniors over 80 (JAMA, Sep. 17, 2014).

Do Older People Need to Lower Their High Cholesterol?

Scientists noted that people in their 70s, 80s and 90s have not been included in randomized controlled trials to test the benefits of statins. Despite the lack of evidence, there seems to be a growing trend to prescribe statins to older people.

According to the authors of the JAMA report:

“Statin use for primary prevention is also increasing among people older than 80 years, as shown in recent population-based surveys. In a large US survey, the prevalence of use was 29% in persons aged 80 to 84 years, 24% in those aged 85 to 89 years, and 14% in those older than 90 years.”

What About Side Effects?

We have worried for years that some older people get prescriptions for statin medications that may cause them distressing side effects without strong evidence that they will benefit from cholesterol control. Unless a person has diabetes or heart disease, we recommend questioning such a prescription, just to make sure that the rationale for taking the drug is solid.

Because kidney and liver function may be declining as we age, older adults might be more vulnerable to statin side effects (such as muscle pain, weakness, or cognitive difficulties) than younger people, and should be given statins only if they are clearly warranted.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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My mom is 78 and has high cholesterol. She has no heart disease or hear problems. The other night she woke with chest pain. The doctor thought it was reflux, but because of her age and high cholesterol wanted to do a calcium scoring test. Her total score was 1137. Now he wants to put her on a statin. I’m unsure. Should the calcium scoring carry that much weight? Yes, her cholesterol is up, but she is very healthy, only taking meds for her thyroid. What information do you have about calcium scoring tests and their reliability to predict heart disease?

The first time I had my cholesterol tested was 1996, and the total was 300. I was put on lipitor, and after reading the side effects I stopped it. I am now 83, and my cholesterol is 297. I am taking no meds. I have lived this long and will take my chances.

My doctor is “fixed” on the algorithm of blood pressure vs labs. I am a 73 year-old female who walks 2-3 hours a day in a very hilly area and hikes in the mountains. As an experiment, I will take red yeast rice over the counter with niacin, 600mg a day vs the prescribed 1200mg a day. I will do this until my next labs and see how it works on the labs. Touch wood, after 90 days no side effects. I hiked St Helen’s and Rainier, and my legs held steady.

I have been on statins since before I was 54. At 54 I had to have a double bypass. I was complaining already of joints that ached so bad I couldn’t stand to exercise. My heart surgeon told me that he would never take a statin drug or he wouldn’t be able to stand to do surgeries.

I have always had muscle pain since starting on statins but I attributed part of it to the type of work that I did. My concern is muscle atrophy in my legs, I don’t want to end up using a walker and I have discussed this with my heart doctor and PCP and they just dismiss and tell me that I need to stay on it. It feels like I have no muscle at all in my rear, it hurts to sit all of the time.

Also, the ED that I have experienced since being on statins which the doctor has dismissed. As long as it doesn’t effect them. All in all I am afraid to stay on the statin, Crestor, and afraid to get off it.

I am not a diabetic & have been taking lovastatin for several years with no side effects. I am 82 years old. It all depends on the individual.

Several years back, my Primary Care Physician put me on the generic version of Lipitor. I am a Type 2 Diabetic currently on insulin. It was not until a few years later that I learned about side effects.

Before I learned about side effects–thanks to reading Peoples Pharmacy–I experienced muscle weakness in my legs. I would be walking and then have no control over my leg and would trip. I thought it was related to diabetic nephropathy.

About two years ago, during a physical, I mentioned the muscle weakness to my doctor and he immediately took me off the statin. I did not make the connection at that time.

He later prescribed me a different statin. About that time, I had read about side effects and kept a closer eye.

Almost immediately, I experienced the muscle weakness again. I reported it and he put me on Crestor–every other day.

On Crestor, I experienced constipation and tiredness. I felt as though my cancer had returned–was diagnosed with liver cancer in 2013, and had liver resection in 2014.

Anyway, somewhere in Peoples Pharmacy said to try an experiment: stop taking the statin for a week and see what happens. My constipation went away and I had more energy.

Then, I went back on the statin. The side effects came back, including the muscle weakness.

Unfortunately, my regular physician retired, so I have not reported that I stopped taking the statin. I will tell my new primary care physician when I have my “patient transfer” appointment.

anything that alters Acetylcholine in my brain scares me. I will not take statins. I use diet control for cholesterol.

Many years ago I read a book by Shane Ellison who warned in one chapter about the horrible side effects of statin drugs (muscle weakness, mental decline, etc.), particularly Simvastatin, a statin my husband was on, as well as Metoprolol. I let him read that article and decide for himself if he wanted to discontinue it or not because his cardiologist suggests staying on it. I read with interest all the articles I can find about statins (mostly negative) and I do share them with him. My husband is almost 71 and is not diabetic, but has experienced some of the negative statin side effects and does not want them to progress even further. However, he has two stents inserted in 2005, the time he began Simvastatin. Any comments about the necessity/urgency to continue taking them would be appreciated. He is considering an every-other-day regimen to see what happens.

A couple of years ago,my mother at 93, went into assisted living in a very upscale facility in PA. SHE WAS ON NO MEDS. The doc there put her on a statin and now she is on 5 different meds. I told her she should not be taking statins. But the doctor has her afriad not to. I say to this so called doctor. FIRST DO NO HARM.

I’m diabetic but frankly I would rather live five years less and feel good than take a statin and feel bad every day. Quality of life is much more important than quantity.

Well, statins are VERY lucrative. If you can get everyone on them , regardless of health, verified disease, age, or any other factor, you CAN make a lot more money! Let’s face it… the driving force in medicine IS money, money, money. Perhaps that’s why it seems that now the “annual exam” is” let’s run a bunch of tests” then,(based on often surrogate findings), prescribe a bunch of drugs. It also seems that agreeing to one prescription starts a cascade and soon you need 5 or 7 or 10. I think that’s exactly the plan and the health of the populace be damned. It also seems all these drugs have nothing to do with improving the QUALITY of life. As long as some often arbitrary seeming values are met, whether your crippled, sick, (of course that would mean more drugs I guess), or living with devastating and often irreversible side effects does not enter the equation.

Is there any info for a 78 year old woman who has taken statins for over10 years. Is there residual benefit of long term use?

This study included only individuals who started a statin during that age range. It doesn’t seem to address individuals who began a statin prior to age 75 as to whether there was benefit that endured, or dissipated, after age 75.

I take no statins. I’m 77 and recently had tests run. And guess what? My arteries are completely clear! Not even any calcium buildup. Even though doctors have been telling me for years that I’m going to die from high cholesterol (287). I refuse to take statins because the side effects from statins are so severe for me I’d rather be dead!

At 76 yrs of age, with no diabetes or heart disease, I would never take a statin! EVER! Too many side effects & I am the queen of side effects. I even suffered a rare side effect of a hip replacement. Severe femoral nerve compression! Happens in 1 to 2% of patients. So no statins for me!!

My total cholesterol is 162 on no statin. Flaxseed meal on my oatmeal for breakfast daily and a little flaxseed meal on meals throughout the day. Before I stopped rosuvastatin for muscle pain my total cholesterol was 101. I am 69 and refuse statins.

I was first given Lipitor in my 60’s and found it debilitating; I got every side effect in the book.

Since then I have, at the consternation of a couple of doctors, refused to take any statin medication. At 79 I find my major problems are more related to arthritis and lack of energy.

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