Stopping Statins for Primary Prevention After Age 75? Evidence from a Randomized Trial

In adults aged 75 years or older without a history of atherosclerotic cardiovascular disease (ASCVD) who were taking statins for primary prevention, discontinuing statin therapy was non-inferior to continuing treatment with respect to 3-year all-cause mortality. In the French multicentre, open-label, phase 3 randomised controlled trial, 1,180 participants were assigned to continue or stop statins, with 1,160 included in the primary analysis; their median age was 80 years, 66.8% were women, 29.5% had diabetes, and 77.2% had high blood pressure. At 36 months, mortality was 7.9% in the continuation group and 7.2% in the discontinuation group, an absolute difference of −0.68%, meeting the prespecified non-inferiority criterion. Adverse events were similarly frequent in the continuation and discontinuation groups (73.1% vs 74.0%), as were non-cardiovascular adverse events (72.3% vs 72.7%). The findings suggest that, among adults aged 75 years or older receiving statins for primary prevention without previous ASCVD, stopping statin therapy did not increase 3-year all-cause mortality compared with continuing treatment and support individualized decision-making about statin discontinuation in older adults. Source: https://www.thelancet.com/