Mil­lions of over-75s ‘get no ben­e­fit’ from their statins

Daily Mail - - News - By Ben Spencer Med­i­cal Cor­re­spon­dent b.spencer@dai­ly­

GIV­ING statins to the healthy el­derly could be a waste of time, a ma­jor study claims.

The re­search, in­volv­ing 47,000 over75s, found no ev­i­dence that they make any dif­fer­ence to low-risk pa­tients.

Sci­en­tists said their re­sults ‘do not sup­port the wide­spread use of statins’ in this group. The news threat­ens to in­flame the row about the pros and cons of the drugs,which re­duce lev­els of so- called ‘bad’ choles­terol to pre­vent heart dis­ease.

Since 2014, all over-75s in Bri­tain have been el­i­gi­ble to take statins – which cost no more than £20 a year – even if they are in per­fect health. This ap­proach – known as pri­mary preven­tion – means any­one with a 10 per cent chance of get­ting heart dis­ease within ten years should have the med­i­ca­tion. The just-in- case strat­egy means all over-75s, most over-60s and some as young as 30 – are el­i­gi­ble for the pills.

Ex­perts agree that statins are life­savers for two mil­lion peo­ple who have heart dis­ease or di­a­betes – par­tic­u­larly those who have al­ready had a heart at­tack or a stroke. But many doc­tors ques­tion what they call the ‘over-med­i­cal­i­sa­tion’ of the fur­ther ten mil­lion healthy peo­ple who are el­i­gi­ble for statins based on the like­li­hood that they might be­come ill. Of the to­tal of 12mil­lion el­i­gi­ble, many are re­luc­tant to take a pill for no ob­vi­ous rea­son. As a re­sult, only around six mil­lion agree to take the drugs.

The lat­est find­ings, pub­lished in the Bri­tish Med­i­cal Jour­nal, sug­gest most el­derly peo­ple do not ac­tu­ally ben­e­fit from the pills. Span­ish sci­en­tists, led by the Cata­lan In­sti­tute of Health and the Univer­sity of Girona, tracked 46,864 peo­ple over 75.

The par­tic­i­pants – none of whom had heart dis­ease at the beginning of the study – were mon­i­tored for six years.

For most, the sci­en­tists found no ev­i­dence that use of statins re­sulted in a re­duc­tion in car­dio­vas­cu­lar dis­ease or deaths.

The only peo­ple who ben­e­fited were those with type 2 di­a­betes aged 75 to 84, for whom the risk of car­dio­vas­cu­lar dis­ease went down by 24 per cent and the risk they would die dur­ing the study fell by 16 per cent. But even for this group, the pro­tec­tive ef­fect fell af­ter 85 and dis­ap­peared by the age of 90. The re­searchers, led by Dr Rafel Ramos, said statin use for the el­derly had in­creased around the world de­spite a lack of ev­i­dence for any ben­e­fit, even though the el­derly are more prone to side-ef­fects.

The re­port con­cluded: ‘ These re­sults do not sup­port the wide­spread use of statins in old pop­u­la­tions, but do sup­port treat­ment in those with type 2 di­a­betes younger than 85.’ But Pro­fes­sor Colin Baigent, of the Univer­sity of Ox­ford, crit­i­cised the way the study was de­signed, adding: ‘The prob­lem with this type of study, which used rou­tine health records, is that it is a very un­re­li­able way to de­ter­mine the ef­fects of statins on the risk of heart at­tacks and strokes.

‘The only suit­able method is a clin­i­cal trial where peo­ple are al­lo­cated to a statin or to no statin en­tirely at ran­dom.’

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