Statin therapy is known to reduce major vascular events and vascular mortality, but uncertainty exists about the efficacy and safety of such treatment in people older than age 75. The Cholesterol Treatment Trialists' Collaboration database offers access to age-specific data on vascular events, cause-specific mortality, and cancer from 28 randomized controlled trials of statin therapy. Using these data, researchers conducted a meta-analysis of all large statin trials, comparing the effects of statin therapy at different ages and, specifically, its effects on older adults.

Of the 28 trials included in the analysis, 23 compared statin therapy with placebo or usual care and five compared more intensive statin therapy with less intensive statin therapy. The median duration of follow-up was 4.9 years, and 8% of the 186,854 participants were older than age 75. In all trials, statin therapy or a more intensive statin regimen compared with control therapy or a less intensive statin regimen produced a 21% proportional reduction in the risk of a first major vascular event (major coronary events, revascularization, and stroke) per each 1 mmol/L (38.67 mg/dL) reduction in low-density lipoprotein (LDL) cholesterol. Risk reductions were observed in all groups, including among those older than age 75. Proportional reductions in risk decreased slightly with increasing age, but this trend wasn't significant.

Statin therapy or more intensive statin therapy produced a 24% proportional reduction in major coronary events and a 25% proportional reduction in the risk of coronary revascularization procedures per each 1 mmol/L reduction in LDL cholesterol. There was a statistically significant trend toward smaller proportional reductions in major coronary events with increasing age but not in the risk of coronary revascularization procedures and stroke. Statin therapy reduced vascular mortality by 12% per each 1 mmol/L reduction in LDL cholesterol, with no significant differences by age. It had no effect on nonvascular causes of death or on cancer incidence or death.

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