Statins are cost effective and improve health outcomes for the over-70s with or without previous cardiovascular disease, a large UK modelling study has concluded.
The findings support their routine use in most people in this age group, the team from the University of Oxford concluded.
With an ageing population, the over-70s now make up around 30% of people over the age of 40 in the UK, yet despite their increased cardiovascular risk use in this older group is lower, the researchers noted in the journal Heart.
The study used an up-to-date cardiovascular disease model developed from UK populations including the Biobank cohort which included information on their safety and effectiveness in older people.
Projected cardiovascular risk figures including on survival, quality-adjusted life years (QALYs) and healthcare costs of statin use were calculated in 5103 people with previous cardiovascular disease and in 15,019 without.
Use of statins was found to be cost-effective with the cost per QALY gained below £3,502 for standard therapy and below £11,778 for higher intensity therapy.
The team did note that there was a larger degree of uncertainty among older people without previous cardiovascular disease where risk reductions were substantially smaller.
There are two ongoing statin trials in older people without cardiovascular disease which ‘will add valuable data’ particularly in those over the age of 75 years, the researchers said but their findings were robust enough to recommend statin treatment in this age group now.
Lead study author Borislava Mihaylova, an associate professor at Oxford Population Health said: ‘Lifetime statin treatment increased quality-of-life-adjusted survival in older men and women and, at UK cost of generic statins, was highly cost-effective for all, irrespective of their CVD history or LDL-C level.
‘Higher intensity statin therapy was the strategy likely to bring the highest health benefits cost-effectively, although standard statin regimens would achieve most of these benefits.’
She continued: ‘While further randomised evidence will be helpful, the robustness of these findings indicates that older people are likely to benefit cost-effectively from statin therapy and should be considered for treatment.’
Dr Gavin Stewart, reader in interdisciplinary evidence synthesis at Newcastle University, said: ‘The finding that statins are cost effective and linked to better health outcomes in older people is likely to be robust.
‘It is based on sound analysis and interpretation of well conducted individual patient data meta-analysis and modelling.
‘Notwithstanding the uncertainty associated with modelling observational data, it appears that statins are likely to improve health in average older people.’
