In a retrospective cohort study published in the European Heart Journal, patients who discontinued statin treatment after the age of 75 had a 33% increase in the risk of hospitalisation for a cardiovascular event.
'To patients, we would say that if you are regularly [taking] statins for high cholesterol, we would recommend you don't stop the treatment when you are 75,' said endocrinologist Dr Philippe Giral and colleagues. 'To doctors, we would recommend not stopping statin treatment given for primary prevention of cardiovascular diseases in your patients aged 75.'
The researchers used French national health insurance databases to identify all the people who turned 75 between 2012 and 2014 and had been taking statins for at least 80% of the time over the previous 2 years. Only people taking statins for primary prevention were studied: those diagnosed with cardiovascular disease or taking other medications for cardiovascular conditions were excluded.
A total of 120,173 people were followed for an average of 2.4 years. Of these 17,204 (14.3%) discontinued statins for at least 3 consecutive months and 5396 (4.5%) were admitted for a cardiovascular event.
Analysis showed that people who discontinued their statins had a 33% increased risk of hospitalisation for a cardiovascular event. The association was strongest for cardiac problems: there was a 46% increased risk of a coronary event, while the increased risk of a vascular problem, such as stroke, was 26%.
The researchers say their study is the first to evaluate the impact of discontinuing statins taken for primary prevention in older people. They stress that the observational nature of the study means that it cannot prove that discontinuing statins increases the risk of cardiovascular events in this population, only that it is associated with an increased risk. Randomised interventional studies will be needed to establish causation.
The team found an unexpectedly low statin discontinuation rate (14.3%) among the people they studied, but they believe this is because they included only people who had been taking statins continuously for the previous 2 years.