Scientists from the Queen Mary University of London found stopping statin treatment early could substantially reduce lifetime protection against heart disease since a large share of the benefit occurs later in life.
They that people in their 40s with a high likelihood of developing heart disease and people of all ages with existing heart disease should be considered for immediate initiation of cholesterol-lowering treatment.
Heart disease is the most common cause of ill-health and death worldwide, and high cholesterol is a key modifiable risk factor.
Strong evidence shows that reducing low-density lipoprotein cholesterol (‘bad’ cholesterol) by 1 mmol/L with statins reduces the risks of heart disease and stroke by 24%-25%.
Statins are the most commonly used lipid-modifying drug—it is estimated that in 2018, they were taken by more than 145 million people. However, delayed treatment initiation and poor adherence are common.
Exaggerated claims about side effects of statins may also be responsible for under-use among individuals at increased risk of cardiovascular events.
In the study, the team analyzed data from 118,000 participants of large international statin trials and 500,000 people in the UK Biobank population cohort.
Treatment with a standard dose of statin (40 mg daily) was used to estimate the effect of therapy versus no therapy
The benefit of statins was measured in quality-adjusted life years (QALYs), which is the length of life adjusted by health to reflect quality of life. One QALY is equal to one year of life in perfect health.
The researchers found that a large part of QALYs gained with statin therapy accrued later in life.
The higher the participants’ 10-year heart disease risk, the larger and earlier the statin benefit accrued.
Compared with lifelong statins, stopping therapy at 80 years of age erased a large share of the potential benefit, especially for people with relatively low heart disease risk.
This study suggests that people who start taking statins in their 50s but stop at 80 years of age instead of continuing lifelong will lose 73% of the QALY benefit if they are at relatively low heart risk and 36% if they are at high heart risk.
Women’s cardiovascular risk is generally lower than men’s. This means that for women, most of the lifelong benefit from statins occurs later in life and stopping therapy prematurely is likely more detrimental than for men.
If you care about heart health, please read studies about why an avocado toast may be the key to a healthy life, and this drug could help lower obesity, fatty liver, improve your heart health.
For more information about heart health, please see recent studies about plastics linked to heart disease and high cholesterol, and results showing drinking red wine for heart health? Read this before you toast.
The research was presented at ESC Congress 2022 and conducted by Dr. Runguo Wu et al.
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