Evidence supports the use of statins for the secondary prevention of cardiovascular disease (CVD) in patients ages 75 years and older. However, it does not support the use of these medications for the primary prevention of CVD in people in this age group. Nonetheless, according to current guidelines, most patients age 75 or older are eligible to take statins based on their 10-year risk of developing CVD.

A retrospective cohort study using data from a clinical database of more than 6 million primary care patients was designed to determine whether statin use was associated with a lower incidence of atherosclerotic CVD and mortality in older patients with or without type 2 diabetes and no history of CVD. Of the nearly 46,864 patients who fulfilled the inclusion criteria, 7,502 started statin treatment during the enrollment period and 7,880 had type 2 diabetes. Median follow-up was 7.7 years.

In patients who did not have diabetes, statin treatment wasn't associated with a reduction in atherosclerotic CVD or all-cause mortality in those 75 to 84 years of age or age 85 or older. By contrast, in patients who had diabetes, statins reduced the incidence of atherosclerotic CVD by 24% and all-cause mortality by 16% in those 75 to 84 years of age. This protective effect, however, was substantially reduced in those age 85 or older and disappeared in nonagenarians.

These findings don't support widespread use of statins in old and very old patients, but they do support statin treatment in patients with type 2 diabetes who are younger than age 85, the authors conclude.

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