Re: Statin use in older patients

Issue: BCMJ, vol. 56, No. 2, March 2014, Page 81 Letters
By: Adi Mudaliar, MD, CCFP
Related To:

Re: Statin use in older patients (July/August 2013) 
Re: Statin use in older patients (September 2013)

I disagree with my colleagues’ points of view regarding statin use for the elderly. Statin therapy is effective in reducing cardiovascular risks.

In a Medical Research Council and British Heart Foundation heart protection study[1] there were nearly 6000 patients older than 70 and more than 1200 aged 75 to 80 at the start of the study. Reduction of cardiovascular events with simvastatin was the same for the elderly as for younger participants. In the Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin,[2] the 5695 patients who were over 70 years old had the same magnitude of risk reduction in cardiovascular events with rosuvastatin as younger patients. Finally, the Prospective Study of Pravastatin in the Elderly at Risk[3] showed a 15% reduction in the risk of coronary death, nonfatal MI, and stroke. This study enrolled 5804 patients between the ages of 70 and 82.

In my view the elderly should not be denied statin therapy.
—Adi Mudaliar, MD
Vancouver

References

1.    Heart Protection Study Collaborative Group. MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: A randomised placebo-controlled trial. Lancet 2002;360:7-22.
2.    Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 2008;359:2195-2207. 
3.    Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomised controlled trial. Lancet 2002;360:1623-1630.

Adi Mudaliar, MD, CCFP. Re: Statin use in older patients. BCMJ, Vol. 56, No. 2, March, 2014, Page(s) 81 - Letters.


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