news
Statin and
stoppin’
New study unpacks common
drug concerns.
By Dallas Bastian
S
tatins seem to make headlines
across Australia every year – some
touting the benefits and safety,
others warning of side effects.
No example of the power of media
coverage on the class of cholesterol-
lowering drugs is as pertinent as that of
ABC TV’s Catalyst program. The 2013
report questioned the effectiveness of
statins and, according to one study, led
more than 60,000 Australians to cut back
or stop taking the drugs.
Health organisations rallied to ease
concerns. And they continue to do so as
headlines about safety versus effectiveness
continue, particularly in relation to
older adults.
Now, Australian and international
researchers have released a study that
holds statin therapy is both effective and
safe for people aged over 75 years.
Published in The Lancet, the study
summarised all available evidence from
major trials to help clarify the issue.
It revealed significant reductions in
major vascular events in each of the six
age groups considered, ranging from
under 55 to over 75 years.
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agedcareinsite.com.au
The study also found that statin therapy
did not increase the risk of deaths from
non-cardiovascular disease, or the risk of
cancer, at any age.
Co-investigator Dr Jordan Fulcher from
the University of Sydney said statin therapy
appears to be just as effective in people
aged over 75 years as it is in younger people.
“We now have definitive evidence that
statins benefit older people who have
suffered a heart attack or stroke,” he said.
The picture of cardiovascular risk
reduction was less clear among people
over 75 without pre-existing vascular
disease. But the team said a new trial is
studying the effects of statins in more
depth in healthy older people.
“More information in this group of
people would help confirm the same
benefits that we see in our overall trials
population,” Fulcher said.
In a linked editorial, Bernard Cheung and
Karen Lam from the University of Hong
Kong reminded readers that no drug is
completely harmless.
They wrote: “When statins are used in
people with low cardiovascular risk, the
risks and benefits need to be weighed
against each other.
“Statins have been associated with a
slight increase in incidence of muscle
pain, diabetes and haemorrhagic stroke,
but their benefits in prevention of major
vascular events are shown to be much
greater.
“The present meta-analysis that
includes people older than standard trial
populations echoes this conclusion.
“The challenge for the healthcare
profession and the media is to convey
risks and benefits in ways that patients can
understand, enabling them to make an
informed choice.”
Still, Fulcher said that this new study will
“provide reassurance and guidance for
doctors and patients alike that people are
not automatically ‘too old’ for treatments
like statins to be effective”.
Fellow researcher Professor Colin
Baigent, from the University of Oxford, said
while the risk of heart attacks and strokes
increases markedly with age, statins are
not used as widely in older people as they
should be.
“Since the risk of heart attack and
stroke increases with age, the potential
benefits are likely to be even greater for
older people.
“Therefore, there is a need to ensure that
patients at risk of cardiovascular disease
due to their age are offered statin therapy
where there is good reason to believe that
it will be beneficial.
“Anyone with concerns about whether
statin therapy is suitable for them should
discuss this with their GP.” ■