CholesterolNewsletterSurgery & Meds

Stopping statins

Executive summary

* A study was published in JAMA Open Network, which generated the headline ‘stopping statins linked to death and cardiovascular events in the elderly.’

* The study reviewed data from residents in Italy, aged 65 or older, who were taking several medications and then stopped prescriptions for statins while continuing the other drugs.

* Approximately 4,000 patients who discontinued statins were matched with the same number of patients who continued to get prescriptions for statins.

* The study reported that compared to people who continued statins, people who stopped statins experienced 24% higher hospitalisations for heart failure, 14% higher hospitalisations for any cardiovascular outcome, 15% higher deaths from any cause and 12% higher emergency admissions to hospital for any cause.

* Those were the relative risks. The absolute risk difference for the largest number (24%) was 12.5 per 1,000 person years.

* There were several non-findings. There was no difference in hospitalisations between those who stopped statin prescriptions and those who didn’t for cerebrovascular disease (strokes), ischemic heart disease and neurological disorders.

* There were procedural issues in the study, such as it cannot be assumed that people who cashed a prescription took the tablets. Also, a patient in the 'discontinued' group could be matched with someone who also discontinued statins but did so at least 180 days later than they did.

* The reason for stopping is important. If patients stopped because cholesterol was low, then low cholesterol could be associated with high events – the statin cessation could just be the marker. If patients stopped because side effects were being suffered, they need to be respected for making informed choices when weighing up experienced harm vs possible benefit.


The rest of this article is available to site subscribers, who get access to all articles plus a weekly newsletter.
To continue reading, please login below or sign up for a subscription. Thank you.