STOPPING STATINS AFTER 70: WHAT A MAJOR NEW TRIAL MEANS FOR YOUR PARENTS
If your mum or dad has been taking statins for years, a major new trial may give your family something to talk about at their next GP visit.
The research, published in The New England Journal of Medicine on November 7, looked at whether people over 70 without heart disease can safely stop taking the cholesterol-lowering tablets.
The short answer is generally yes, though there is a small but real catch that is worth understanding.
What the statins trial looked at
The study, called STREAM, was presented at the American Heart Association's Scientific Sessions in Chicago over the weekend.
Researchers enrolled 1,880 adults aged 70 and older at 24 clinical centres across Switzerland, France and the Netherlands.
The average age was 77, and almost half of the participants were women.
Everyone had at least two chronic health conditions, such as a past cancer or lung disease, but no history of heart attack, stroke or other cardiovascular disease.
They had all been taking a statin to prevent heart problems, rather than to treat an existing one, for at least a year.
Half were randomly assigned to stop their tablets, while the other half carried on as usual.
The headline finding
Over roughly two years, stopping did not significantly increase the combined risk of heart attack, stroke or death, according to the American Heart Association.
Just as importantly for daily life, there were no differences between the groups in quality of life, muscle pain, falls or muscle wasting.
That matters, because muscle aches are one of the most common reasons people say they dislike taking statins.
Study author Professor Rita Redberg, a cardiologist at the University of California, San Francisco, said discontinuation "is safe for most people who are in this age group" without a previous heart event.
The small catch
Here is the part worth a careful read.
When the researchers followed people for longer, up to about four years, 12.7 per cent of those who stopped had a heart attack or stroke or died, compared with 9.2 per cent of those who kept going.
The team estimated about one extra major heart event or death over two years for every 40 people who stopped.
According to HCPLive's report on the trial, cholesterol levels also climbed noticeably in the group that stopped.
After the trial, an independent safety board recommended that people who had stopped discuss restarting with their doctor.
Professor Redberg was clear that the results should not become a blanket rule, and that decisions should be shared between patients and their health professionals.
Why statins and older age are a tricky mix
Many older Australians juggle a long list of medications, and every extra tablet adds cost, side effect risks and the chance of mix-ups.
Doctors call this polypharmacy, and it is a growing focus for researchers looking at healthy ageing.
There has been little hard evidence on what happens when someone in their late 70s with several health conditions stops taking a statin.
This trial is one of the first large, randomised studies to help fill that gap.
It is worth noting that participants knew which group they were in, and some swapped groups during the study, although extra analyses suggested this did not change the overall conclusions.
What it means for your family
The most important message is simple: nobody should stop taking statins on their own because of a news story.
If you are caring for an older parent, this could be a good prompt to book a medication review with their GP or pharmacist.
Questions worth asking include why the statin was first prescribed, whether their heart risk has changed, and how they feel about the trade-off between fewer tablets and a slightly higher long-term risk.
Bring a full list of their medicines, including vitamins.
It also helps to know that this trial only included people without existing heart disease, so it does not apply to anyone who has had a heart attack or stroke.
For some families, keeping the statin will be the right call, and for others, cutting back may make life a little simpler.
Either way, the best decision is one made together with a doctor who knows the whole picture.
