By Colin Kenny, Editor – Diabetes Distilled
In this study investigators assessed whether statin treatment is associated with a reduction in atherosclerotic cardiovascular disease (ASCVD) and mortality in old and very old adults with and without diabetes. Participants were stratified by the presence of type 2 diabetes and whether they were new statin users or non-users. Statins had no effect on mortality in people aged over 74 who did not have diabetes. In people with diabetes, however, statin use was statistically associated with reductions in ASCVD incidence and in all-cause mortality. This effect decreased after 85 years and disappeared in nonagenarians.
This retrospective cohort study examined a Spanish primary care database from 2006 to 2015. The researchers discovered 46,864 people aged 75 years or older without atherosclerotic cardiovascular disease, excluding those with a history of cardiovascular disease. Participants were stratified by the presence of type 2 diabetes and whether they were new statin users or non-users. A new statin user was anyone who received statin treatment (simvastatin, pravastatin, lovastatin, fluvastatin, rosuvastatin or atorvastatin) for the first time.
Researchers found that statins were not associated with a reduction in ASCVD or all-cause mortality in primary prevention in people without diabetes who were over 74 years of age. However, in people with type 2 diabetes statins were significantly related to a reduction in ASCVD incidence and all-cause mortality. This effect was substantially reduced after the age of 85 and there was no effect in nonagenarians.
The investigators felt that the results do not support the widespread use of statins in old and very old populations, but they do support treatment in people under 85 years who have diabetes.
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