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Stopping statins treatment in old age increases heart attack risk by nearly half, major study warns

The new research is the largest study of its kind - PA
The new research is the largest study of its kind - PA

Pensioners should not stop taking statins just because they feel healthy, scientists have warned after finding that doing so may boost the risk of heart attack by nearly half.

The first major study to assess what happens when older people with no history of heart disease discontinue the drugs found a substantial increase in the risk of life-threatening events.

The cholesterol-lowering drugs, used by around seven to eight million people in the UK, are well known to benefit patients who have already survived major scares such as a heart attack or stroke.

But until now it has not been clear how effective they are at preventing such problems in the first place.

Policy surrounding so-called “primary prevention” has been plagued by controversy, with some academics accusing health chiefs of prescribing statins - which can cause cramps and other side-effects - to largely healthy pensioners, based on little more than their age.

However, the new study of 120,173 people who turned 75 between 2012 and 2014 found that those who stopped taking statins had a 46 per cent greater chance of suffering a major coronary event, such as a heart attack, within two and a half years.

There was also a 26 per cent increased chance of having a stroke.

Published in the European Heart Journal, the findings suggest the current prescription guidelines for older people are having a positive effect.

Professor Sir Nilesh Samani, medical director at the British Heart Foundation, said:  “Old age itself, particularly reaching the age of 75 and above, puts people at increased risk of a heart attack or stroke.

“This risk can be heightened by factors such as high cholesterol, diabetes and high blood pressure, even in those who are otherwise seemingly healthy.

“Concern has been raised about the benefits of statins in older people.

“This study, although observational, adds to a growing body of evidence showing that statins reduce heart attacks and strokes in older people, as they do in younger people, and are safe.

“Age should not be a barrier to prescribing these potentially life-saving drugs to those people who are likely to benefit.”

Approximately 7.4 million people in the UK live with some form of cardiovascular disease, with more than 168,000 dying each year, according to the Office for National Statistics. Many of the diseases are related to high cholesterol.

The National Institute of Health and Care Excellence says statins should be prescribed when doctors believe there is a 10 per cent or higher risk of developing a cardiovascular disease within a decade.

The patient’s cholesterol levels and age are used to calculate the risk.

However, the criteria has been criticised for its “blanket” approach.

Conducted in France - where the prescription criteria are comparable to the UK - the new study found there would be an extra 2.5 cardiovascular events per 100 people within four years among those who discontinued their statins at the age of 75 compared to those who did not.

Previous international studies have found that non-adherence rate for statins is 40 per cent among people aged 65 and over.

Dr Philippe Giral, who led the new research at the Assistance Publique-Hôpitaux de Paris, said: “To patients, we would say that if you are regularly taking statins for high cholesterol, we would recommend you don’t stop the treatment when you are 75.

“To doctors, we would recommend not stopping statin treatment given for primary prevention of cardiovascular diseases in your patients aged 75.”