# Statin use in older people primary prevention on cardiovascular disease: an updated systematic review and meta-analysis

## TL;DR

This study finds that statin use in older adults significantly reduces the risk of cardiovascular disease and related deaths.

## Contribution

An updated systematic review and meta-analysis on statin use for CVD prevention in older people.

## Key findings

- Statin use was associated with a 46% reduction in all-cause mortality in older people.
- CVD mortality risk decreased by 49% with statin use.
- Statin use showed a 25% reduction in total cardiovascular events.

## Abstract

Evidence on statin use for primary prevention of
cardiovascular disease (CVD) in older people needs to be extended and updated,
aiming to provide further guidance for clinical practice.

PubMed, EMBASE, Cochrane Library and Web of Science were searched for eligible
observational studies comparing statin use vs. no-statin use for primary
prevention of CVD in older people (age ≥65 years). The primary outcomes
were all-cause mortality, CVD mortality, coronary heart disease (CHD)/myocardial
infraction (MI), stroke and total CV events. Risk estimates of each relevant
outcome were synthesized as a hazard ratio (HR) with 95% confidence interval
(95% CI) using in the random-effects model.

Twelve eligible
observational studies (n = 1,627,434) were enrolled. The pooled results suggested
that statin use was associated with a significantly decreased risk of all-cause
mortality (HR: 0.54, 95% CI: 0.46–0.63), CVD mortality (HR: 0.51, 95% CI:
0.39–0.65), CHD/MI (HR: 0.83, 95% CI: 0.69–1.00), stroke (HR: 0.79, 95% CI:
0.68–0.92) and total CV events (HR: 0.75, 95% CI: 0.66–0.85). The association
in all-cause mortality still remained obvious at higher ages (≥70 years
old, HR: 0.56, 95% CI: 0.44–0.71; ≥75 years old, HR: 0.70, 95% CI:
0.60–0.80; ≥85 years old, HR: 0.85, 95% CI: 0.74–0.97), ≥20%
(HR: 0.47, 95% CI: 0.35–0.62) and <20% diabetic populations (HR: 0.50, 95%
CI: 0.40–0.64), and ≥50% (HR: 0.68, 95% CI: 0.59–0.79) and <50%
hypertensive populations (HR: 0.38, 95% CI: 0.16–0.88).

Statin use was related to a 46%, 49%, 17%, 21% and 25% risk reduction on
all-cause mortality, CVD mortality, CHD/MI, stroke and total CV events in older
patients, respectively. The significant association was also addressed in older
patients and ≥75 years old individuals for CVD primary prevention.