A world-first clinical trial led by Monash University researchers has found that daily statins reduce the risk of first-time heart attacks and strokes by 30 per cent in healthy adults aged over 70. Published in the New England Journal of Medicine, the findings could prompt updated treatment guidelines for millions of older people.
Taking a common cholesterol-lowering medication safely prevents major cardiovascular events in older adults who have never experienced a heart attack, stroke, or heart surgery, according to a landmark study. Until now, the benefits of prescribing daily statins as a preventive measure for otherwise healthy individuals over 75 had remained unclear, leaving physicians without robust trial evidence to guide treatment decisions for this rapidly growing demographic.
The STAREE Trial Design and Cardiovascular Findings
To address this clinical blind spot, researchers from Monash University analysed cardiovascular outcomes in nearly 10,000 study participants over the age of 70. The decade-long initiative, known as the Statins in Reducing Events in the Elderly (STAREE) trial, enrolled participants with the assistance of more than 3,400 general practitioners across Australia. Researchers excluded individuals who were not living independently, already required statins due to prior cardiac events, or had conditions that could make the medication unsafe.
Participants were randomly assigned under double-blind conditions to receive either a daily statin or a placebo. The trial evaluated atorvastatin at a daily dose of 40 milligrams. The results showed that major cardiovascular events occurred in 6.0 per cent of participants assigned the medication, compared with 8.3 per cent of those assigned the placebo. That absolute difference of 2.3 percentage points translates to a 30 per cent relative reduction in first-time major heart events.
In practical terms, the analysis established that treating 37 older adults with daily statins for nearly six years prevents one major cardiac event, such as a heart attack, stroke, or coronary revascularisation. The findings were published simultaneously in the New England Journal of Medicine and presented at the European Society of Cardiology Congress in Germany.
Disability-Free Survival and Safety Considerations
While the trial successfully demonstrated a reduction in cardiovascular events, it produced a different result for its second co-primary endpoint.
Adherence presented another challenge during the decade-long project: more than 15 per cent of participants discontinued their assigned treatment.
“We can reduce cardiovascular events, but the health burdens of ageing are less amenable.”
Prof Tom Marwick, a cardiologist at Hobart’s Royal hospital
At the same time, specialists noted that the trial data definitively addressed persistent safety concerns regarding cognitive decline.
Guideline Revisions and Clinical Impact
Lead researcher Adjunct Professor Sophia Zoungas emphasised the broader significance of the work.
Other clinicians urged caution regarding global application. Prof James Chong, a cardiologist at Sydney’s Westmead hospital, pointed out that study participants were almost exclusively white with a mean age of approximately 75, meaning the results may require further supporting evidence before they are generalised to diverse populations worldwide.
Продолжение темы
