If you’ve never had any heart trouble or a stroke, should you continue taking statins or give them up? Dr Mark Porter gives his verdict.
Is it still worth taking statins in your eighties? My wife and I are both 82 and have never had any heart troubles or strokes and our GP offered us both statins a decade ago to try to keep it that way.
At the time it seemed sensible but as we got older and are taking lots of other medication – for problems ranging from glaucoma and arthritis to osteoporosis and high blood pressure – we are starting to question whether they are really benefiting us. What is your view?
I understand your reticence. Indeed, until recently, doctors weren't convinced that statins offered much useful protection against a first heart attack or stroke (this is called primary prevention) in people over 80. The case has always been stronger for people who have already had one (secondary prevention). However, research now suggests they can continue to help people like you and your wife too.
The latest study, published in the Journal of the American Geriatrics Society, compared outcomes in nearly 16,000 people over 80 (average age 85), roughly half of whom were on statins, and half were not. Like you, none had pre-existing cardiovascular disease.
Over the four-year study period there were around 1,000 fewer deaths (from any cause) in the group that took statins, which translates into a 31% reduction in death rate. And there were fewer “coronary events” like heart attacks: 167 in the statin group versus 174 in the slightly smaller group not taking statins (a 20% reduction in risk).
The researchers did not measure the numbers of strokes, more's the pity, but they did monitor rates of muscle problems and diabetes (both recognised side effects of statins) and found no significant different between the groups.
However, there are two things to bear in mind. First, this research doesn't prove that statins are responsible for the benefits. There could be other factors at play, not least all the reasons why some people might take statins and others won't or don't.
And second, there is no such thing as an average person in their eighties: some still run marathons, while others will be in nursing homes, so a decision to take statins, or prescribe them, must always be based on the individual and their likely benefit.
Bottom line? As long as I was experiencing no side effects and still enjoying a good quality of life I would carry on taking statins if in my eighties. No one lives forever, but if statins might help delay the inevitable, why not take them?
Have you got a medical question for Dr Mark Porter? He can’t reply individually, but will respond to questions on this page*
Email drmark@saga.co.uk.
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