Oldest patients least likely to receive statins despite potential benefits, study finds

Patients older than age 75 years were less likely than younger patients to receive moderate- or high-intensity statins, regardless of atherosclerotic cardiovascular disease (ASCVD) risk, and experienced more incident disease, a study found.

Researchers conducted a retrospective cohort study of participants ages 65 to 79 years without ASCVD to assess statin treatment patterns and incident ASCVD in this population. Patients were stratified by five-year age blocks and 10-year ASCVD risk category (low/borderline, intermediate, high) based on the Pooled Cohort Equations. Results were published on Sept. 10 by the Journal of General Internal Medicine.

According to the analysis of 54,066 electronic health records obtained from a single health care system, adults older than age 75 years were less likely to be prescribed moderate- or high-intensity statins across ASCVD risk groups (P<0.001 for all). The study authors noted that the effect remained after multivariable adjustment, including for ASCVD risk (odds ratio [OR], 0.80; 95% CI, 0.74 to 0.86). Adults older than age 75 years were more likely to experience incident ASCVD (hazard ratio, 1.42; 95% CI, 1.23 to 1.63). Other groups less likely to receive moderate- or high-intensity statins included women (OR, 0.85; 95% CI, 0.81 to 0.89) and underweight older adults (OR, 0.45; 95% CI, 0.33 to 0.61).

The researchers noted that older adults may have multiple morbidities, frailty, and life expectancy considerations that may affect statin use decisions and that the differences in prescribing may reflect appropriate decision making between older patients and their clinicians.

“Our findings suggest a strong need to clarify these considerations and rigorously evaluate the clinical significance of age-based differences in statin use in older adults for primary prevention, particularly in the context of the age-based differences in ASCVD incidence that we observed,” they wrote.