Research has shown that continuous statin therapy can significantly reduce the risk of cardiovascular diseases (CVDs) in elderly patients. The study revealed a 21% reduction in CVD risk for individuals aged 75-84 and a 35% reduction for those aged 85 and older, with no additional safety concerns.
Study Background
Cardiovascular diseases are a major health concern worldwide, especially among aging populations. Managing high cholesterol is crucial in preventing CVDs. In Hong Kong, 65.6% of individuals aged 65-84 have high cholesterol. While statins have long been used to improve lipid profiles and lower CVD risk, there has been uncertainty about their use for primary prevention in patients aged 75 and older. This uncertainty stems from the lack of representation of older adults in clinical trials, leaving a gap in understanding the benefits of statin therapy in real-world practice. The study aimed to address this gap by analyzing real-world data to assess the long-term advantages and risks of statin therapy in primary prevention for older adults.
Research Methods and Results
The research team analyzed electronic medical records of over 80,000 older individuals in Hong Kong with suboptimal lipid levels and high-risk conditions from 2008 to 2018. By using a novel analytical approach called target trial emulation, the study aimed to mimic the key features of randomized controlled trials (RCTs) in observational studies to reduce bias. The results showed a 21% relative risk reduction and a 5% absolute risk reduction over five years in CVDs for individuals aged 75-84. In those aged 85 and above, the relative risk reduction was 35%, with a 12.5% absolute risk reduction over five years. The study also found no increased risk of adverse events related to statin use, such as liver dysfunction or muscle problems.
Study Significance
The study confirmed the benefits and safety of statin therapy for preventing CVDs in older adults, suggesting that age should not be a limiting factor in considering statin therapy for high-risk patients. Given the growing burden of CVDs in aging populations globally, this research provides valuable evidence supporting the use of statins for primary prevention in this vulnerable demographic.
Professor Cindy Lam Lo-kuen highlighted, “These findings are crucial for guiding clinical decisions on initiating statin therapy for this expanding demographic. The study also introduces a new research approach that can address other important clinical questions related to elderly care in real-world settings.”
The success of using target trial emulation in this study opens up opportunities for future research in geriatric medicine. Professor Eric Wan Yuk-fai emphasized, “Older adults, especially the very elderly, are often underrepresented in clinical trials, leading to a lack of robust evidence on treatments for this group. This innovative study methodology has the potential to provide high-quality evidence in geriatric medicine, enhancing our understanding and improving healthcare outcomes for older populations.”
