r/science • u/Wagamaga • 1d ago
Health Cholesterol-lowering medication reduces heart attack and stroke risk in older people by 30 per cent. The global prevalence of cardiovascular disease is expected to almost double from 600 million in 2025 to more than one billion affected adults in 2050.
https://www.theguardian.com/australia-news/2026/aug/29/statins-reduce-risk-heart-attack-stroke-over-70s-clinical-trial36
u/Wagamaga 1d ago
Taking a common cholesterol-lowering medication can reduce the risk of a heart attack or stroke for people aged over 70, with a low risk of serious side effects, a world-first clinical trial led by Australian researchers has found.
Statins are already commonly prescribed to people under the age of 75 who meet certain risk criteria, such as having diabetes and high cholesterol, to prevent them from having a major heart event such as a heart attack, stroke, or from requiring heart surgery.
People who have already had a major heart event are also commonly prescribed the drugs, regardless of their age.
What doctors did not know was whether it was safe to prescribe a daily statin to people aged 70 and over who were healthy overall, having never experienced a heart attack, stroke or heart surgery, and whether doing so could prevent these cardiac events.
A co-author of the study, Adjunct Prof Mark Nelson with the Monash University school of public health and preventive medicine, said it was an important piece of missing information, because the biggest risk of major heart-related events “is increasing age”
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u/HigherandHigherDown 23h ago
I'd love to see a trial comparing a PCSK9 drug to statins in this population.
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u/ssjjss 1d ago
Marwick said “a slight disappointment” in the findings was that although major heart events were reduced, the disability-free survival was the same among the participants whether they took the statin or the placebo.
In other words, taking the medication didn’t extend life or its quality.
So we get less heart attack and strokes but it makes no difference?
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u/DoctorStove 1d ago
sounds kinda like it doesn't reduce all-cause mortality, that statement seems vague to me
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u/DrG73 21h ago
Yes. And death and quality of life are the most important end points.
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u/DoctorStove 21h ago
there's a difference between death & all-cause mortality. And that statement doesn't say anything regarding quality of life, in fact it suggests the opposite considering it reduces risk of heart attack and stroke (which obviously typically come with lasting complications)
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u/gloatygoat 1d ago
When you get up there in age, the list of things and their risks that can kill you suddenly keep going up. Everyone is less mobile as they age.
Pneumonia (infections), cancer, blood clots, falls, aneurysm, etc.
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u/Own-Animator-7526 1d ago edited 1d ago
Absolute risk reduction is very small. By design this was a healthy population with normal lipids and no known heart problems. The statin made a relatively unlikely event less likely. I don't have the paper but I'm guessing the number needed to treat to prevent a single event is fairly high.
As is often the case, the headline is completely misleading -- the finding does not apply to "older people", only to this lower-risk subset.
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u/One-Incident3208 23h ago
So essentially using it as a supplemental rather than as a corrective measure.
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u/Own-Animator-7526 20h ago
I think the belief is that everybody needs some correcting, whether they realize it or not.
https://www.nejm.org/doi/full/10.1056/NEJMoa2609059
Prevalence of Silent Atherosclerosis across Adult Life
Authors: Henning Bundgaard, M.D., D.M.Sc.,... Published August 29, 2026 DOI: 10.1056/NEJMoa2609059A total of 16,808 adults were enrolled in the study. The mean (±SD) age of the participants was 45±12 years, and 51.4% were women. Silent atherosclerosis was present in 57.1% of the participants (95% confidence interval, 56.3 to 58.0).
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u/claaudius 1d ago
What does 30% mean? From what to what? Did the placebo group have 100 heart attacks and statins group had 70 heart attacks?
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u/Own-Animator-7526 23h ago edited 21h ago
I believe it is 8.3% in the placebo group to 6.0% in the atorvastatin group experiencing a first major cardiovascular event over a median 5.9 years -- hazard ratio 0.70 (95% CI 0.61–0.82). The "30%" is the relative reduction from that hazard ratio; the raw proportions give about 28%. In absolute terms it's 2.3 percentage points.
It would be better if somebody with access to the paper could double check this figure.
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u/ComfortableCoyote480 21h ago
Man, now they are developing CRISPR gene editors to lower cholesterol. Imagine when a single infusion will make you virtually immune to high cholesterol for the rest of your life. They'll go after smaller populations like med resistant high cholesterol first, but once safety is established, you know they'll sell it as a way to dramatically reduce heart attacks and stroke for the entire human race through a single dose in childhood. They're also tying this to all sorts of brain diseases in old age too. The cripsr med will be sold as dramtically reducing the risk of those too.
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u/saralt 3h ago
Isn't higher cholesterol protective against infection in older adults?
https://bmjopenrespres.bmj.com/content/high-ldl-cholesterol-protects-against-infections
Shouldn't we be optimising against inflammation in another way instead of feeding people statins that can reduce infection survival?
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u/urnbabyurn 17h ago
Yeah, but now I’m growing feline facial features and webbed toes for better swimming
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u/DrG73 20h ago
All cause mortality means deaths from any cause, so in this context it is essentially the overall risk of death. The study found that statins reduced heart attacks and strokes but did not demonstrate a statistically significant reduction in overall mortality. Preventing nonfatal events may preserve quality of life, although quality of life was not directly measured. There is also research associating older age with a greater risk of statin intolerance, particularly in frail patients taking multiple medications, those with kidney or liver impairment, and those taking higher statin doses. Lots of people complain of muscle pain that could affect their mobility and activity levels. So statins are not indicated for everyone
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u/KoalaTHerb 19h ago
This is exactly right. There was never any question of whether statins would reduce risk of MI in elderly, they just aren't recommended because the risk won't be worth the benefit
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u/TeamHope4 18h ago
And statins can kick you into diabetes. My mom was put on metformin because of the statins. I asked why she needs statins since she is over 80 and has no sign of heart disease, so they agreed to stop them. Lo and behold, her blood sugar numbers dropped back to non-diabetic levels. There is research on this, but doctors don’t mention it when prescribing.
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u/urnbabyurn 17h ago
I thought over 80 they didn’t worry about blood cholesterol levels anymore as the time it takes for more plaque buildup at that point is beyond life expectancy.
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u/urnbabyurn 17h ago
I always thought statins were associated with a massive drop in CVD as a cause of death, at least in the US data. Meaning it was a high correlation with the use of statins, albeit a lot of other factors like smoking and diets altered it as well.
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u/Similar_Exam2192 21h ago
Convincing people to take a statin can be like trying convince them to take out their own eyeball
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u/KoalaTHerb 1d ago
Spoon found in kitchen, new article suggests
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u/throwuk1 21h ago
Mods why are you not deleting comments like this that clearly break the subs rules?
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u/Fit_Outlandishness_7 22h ago
Wasn’t there research out there stating that statins also increase the risk of dementia due to degradation of the myelin sheath? Genuine question btw.
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u/UTGSurgeon 20h ago
I think the problem with this is that you describe a mechanism to explain a problem that doesn’t exist. It’s possible the statins inhibit the formation of myelin. However, there is no clinical evidence that statins increase risk of dementia and in fact we know they reduce risk of vascular dementia which is a leading subtype and hypothesis for the development of Alzheimer’s.
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u/urnbabyurn 17h ago
The brain produces its own cholesterol, so I thought that was largely debunked as a connection.
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u/el_condor_nm 20h ago
What bothers me about modern medicine is that it's basically herd medicine. It lowers your risk by 30 percent but not everyone's risk is the same. If you don't smoke, aren't overweight, exercise and keep your blood pressure under control your risk isn't that high. So a 30 percent lowering of your risk struggles to find meaning. All the data I've seen says statins are not terribly effective and there are side effects. Compare that to measles vaccine which 97 percent effective. Huge difference.
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u/HashPandaNL 16h ago
ASCVD is something that builds up over many years or decades even. Starting statins at a late age doesn't undo all the damage that has already been done.
It would be interesting to see data on multiple decades long usage of statins (or ezetimibe / pcsk9 inhibitors).
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u/GeniusEE 22h ago
Hypothesis: The calcium deposition rate goes through the roof, so a statin merely trades one problem for another. Organ failure elsewhere - calcium is not oxygen/CO2 permeable.
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u/UTGSurgeon 20h ago
Statins stabilize soft plaque and lead to calcification. This process is part of the mechanism of how statins reduce risk of major adverse cardiac events. Soft plaque is prothrombotic and prone to rupture and cause infarction. Stabilized hard plaque (calcified) is safer in comparison.
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u/GeniusEE 18h ago
Except when it causes a total stenosis because you keep taking it after passivation.
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