Statins, also known as “cholesterol pills,” work by preventing the liver from making cholesterol. About one-third of adults over 65 years old in the United States current take a statin in the hope of preventing a heart attack.
The most popular statin, Lipitor, is the top-selling drug of all time by a wide margin. Crestor is not far behind. Other statins include Zocor, Pravachol, and numerous generics.
The problem is that there is no evidence that statins work in people over 75, or younger adults without heart disease. The only clear benefit of statins is preventing future heart attacks in people who have had one already.
Even so, the number of statin prescriptions in people 79 years or older has tripled since the 1990s, increasing to 34% over the last decade.
But instead of seeing significantly fewer heart attacks, researchers are seeing a skyrocketing number of older adults developing side effects of statins like diabetes, memory loss, muscle damage, and liver or kidney failure.
Now experts are questioning whether statins do more harm than good. In a study published in JAMA Internal Medicine, researchers analyzed data from a long-running clinical trial called ALLHAT-LLT.
ALLHAT-LIT is a placebo-controlled clinical trial, the gold standard for investigating drug benefits and risks. The researchers randomly assigned 2,900 people to take a placebo or the statin Pravachol (40-mg/day).
Surprisingly, in patients aged 65 to 74 years old, significantly more patients on Pravachol died than patients on a placebo (141 vs. 113). The increased risk of death was even more pronounced in patients over 75 years old on Pravachol or a placebo (92 vs. 65).
The number of deaths was surprising because Pravachol is one of the weakest of all the statins. And while patients on Pravachol did have slightly fewer heart attacks, the effects were not statistically significant.
The researchers concluded that statins have no benefits for older adults without heart disease, and may actually increase the risk of death:
Statin therapy in older adults may be associated with an increased mortality rate should be considered before prescribing or continuing statins for patients in this age category.”
Perhaps it is time for doctors to be more wary of side effects, stop treating statins like a magic pill to prevent heart attacks, and carefully choose patients based on risk-factors like a previous heart attack, stent, bypass surgery, or severe atherosclerosis.
Source: Statin use in older people