Statin Use in Older Adults Could Have Potentially Serious Side Effects

While statins can prevent disease in older adults, they can also cause potentially serious side effects, according to a study published in the Annals of Internal Medicine.

The researchers used a computer simulation model to determine whether statins can be routinely administered to prevent heart disease in adults age 75 years or older. They found that while there were far fewer heart attacks, there were potential side effects such as muscle pain and weakness or mild declines in cognitive function.

“There’s been a lot of uncertainty over the use of statins in older adults,” senior author Kirsten Bibbins-Domingo, PhD, MD, a professor of medicine, epidemiology and biostatistics at the University of California, San Francisco (UCSF), said in a statement. “Prior studies have favored statin use because of the clear benefits to the heart and because serious side effects are rare. Unfortunately, we don’t have enough studies in older adults, and as a result don’t know enough about how common or how severe the side effects are.”

Treating adults between the ages of 75 and 94 years would prevent more than 100,000 myocardial infarctions and 68,000 deaths from coronary heart disease. There are 19 million Americans in this age group, and they are projected to account for 2.5 million myocardial infarctions and 3.1 million coronary heart disease deaths over the next decade, according to UCSF.

In addition, 30% of adults ages 75 to 94 were diagnosed with cardiovascular disease, which statins are widely used to combat. Because statins are relatively inexpensive, treating all older adults without heart disease would still be cost effective, according to the authors. However, the simulation projected a 10%-30% increased risk of cognitive impairments or function limitations.

“At effectiveness similar to that in trials, statins are projected to be cost-effective for primary prevention; however, even a small increase in geriatric-specific adverse effects could offset the cardiovascular benefit,” the authors concluded.