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Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on August 25th, 2024.
If you're over 75, you may be wondering if you should start taking a statin medication to lower your cholesterol and reduce your risk of heart disease. While statins can be beneficial for many people, the decision to start this medication becomes more complex as we age. In this article, we'll explore the factors to consider when deciding whether statins are right for you.
Statins are a class of medications that work by blocking an enzyme in the liver responsible for producing cholesterol. By reducing the amount of cholesterol your body makes, statins can help lower your risk of developing atherosclerotic cardiovascular disease (ASCVD), which includes conditions like heart attack, peripheral vascular disease (PAD), and stroke.
According to a study published in the Annals of Internal Medicine, treating all adults aged 75 to 94 with statins could potentially prevent 105,000 heart attacks and 68,000 deaths from coronary artery disease over a 10-year period. This is because the risk of ASCVD increases with age, and the majority of deaths from these conditions occur in older adults.
While the potential benefits of statins are significant, there are several important factors to consider before starting this medication:
The importance of cholesterol as a risk factor for ASCVD decreases with age
Older adults are at increased risk for adverse effects from statins, such as muscle pain and fatigue
Statins may interact with other medications commonly taken by seniors
Other chronic health conditions may be as likely as ASCVD to contribute to functional decline and cause death
If you're over 75 and don't have ASCVD, it's important to have a conversation with your doctor about whether starting a statin makes sense for you. Your doctor can help you weigh the potential benefits and risks based on your individual health status and medical history.
Over 75 with ASCVD: Continue statin or start if new ASCVD or DM is discovered
Over age 75 and in good health: The decision is individualized, considering overall health status and preferences
Limited Life Expectancy: Consider deprescribing
Over 85 (healthy or not): The benefits may no longer outweigh the risks and side effects
Those with chronic illnesses and multiple medications: Be cautious, as side effects may negate the statin's benefits
Remember, the decision to start a statin should be made in partnership with your healthcare provider. They can help you make an informed choice based on your unique circumstances and health goals. For more information on heart health and cholesterol management, visit the American Heart Association, National Heart, Lung, and Blood Institute, or Centers for Disease Control and Prevention websites.
Continue existing therapy if you have heart disease, but starting new treatment after 75 depends on your overall health and life expectancy rather than cholesterol numbers alone. The decision requires weighing significant cardiovascular benefits against age-related risks that become more prominent in advanced years. If you're navigating these complex medication decisions as a senior, Doctronic can help connect you with appropriate medical guidance.
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