Starting statins at age 70: is it still worth it?
Cholesterol-lowering medication after 70: what does a new study tell us?
A large study in adults aged 70 and over found fewer serious cardiovascular events with cholesterol-lowering medication. However, it did not demonstrate a longer lifespan or longer survival without dementia or lasting physical disability.
Statins are medicines that lower LDL cholesterol. They are prescribed to reduce the risk of cardiovascular disease. But how much benefit does starting a statin later in life offer if you have no known cardiovascular disease?
What did the researchers study?
The Australian STAREE study followed almost 10,000 independently living adults aged 70 and over, without known cardiovascular disease, diabetes or dementia.
About half received atorvastatin daily, with a target dose of 40 mg. The other half received a placebo: a tablet containing no active medicine. Participants were followed for approximately six years.
Fewer cardiovascular events
A serious cardiovascular event occurred in:
approximately 83 out of every 1,000 people in the placebo group;
approximately 60 out of every 1,000 people in the statin group.
This means approximately 23 fewer people experienced such an event per 1,000 people treated, over approximately six years. The absolute difference was 2.3 percentage points.
These events included a heart attack, a stroke, death from cardiovascular disease, or a procedure to restore blood flow through the coronary arteries. The figure describes these outcomes combined.
Were there also fewer deaths?
In the statin group, 395 of the 4,984 participants died. In the placebo group, 433 of the 4,987 participants died.
There were therefore 38 fewer deaths in the statin group. This corresponds to approximately 8 fewer deaths per 1,000 people, an absolute difference of about 0.8 percentage points.
This difference was not statistically significant. This means the study does not provide sufficient certainty to conclude that the treatment reduces overall mortality. The number of deaths from cardiovascular disease was the same: 74 in each group.
The study also found no statistically convincing improvement in survival without dementia or lasting physical disability.
What about side effects?
Muscle symptoms, liver-related problems and diabetes-related adverse events were reported more often in participants receiving atorvastatin. Serious reported adverse events were uncommon and occurred at approximately the same frequency in both groups.
Symptoms experienced during treatment deserve attention. However, they are not always caused by the medicine: participants taking a placebo also reported symptoms.
What does this mean for you?
Starting a statin after 70 is an individual decision. We consider your overall cardiovascular risk, your health, other medicines, possible side effects and what matters to you.
This study involved people without known cardiovascular disease. For someone who has already had a heart attack or stroke, the balance of benefits and risks is different.
If you take a statin and have questions about its benefits, do not stop it on your own. At HAP.GENT, we can review the potential benefit for you together and discuss whether any adjustment is appropriate.
Dr. Didier Hebberecht
Source: STAREE study, The New England Journal of Medicine, 2026. DOI: 10.1056/NEJMoa2607314.