Despite Recs, Statin Use in the Very Elderly Continues to Climb

Use of statins for primary prevention in patients older than 79 years of age without vascular disease increased from 1999–2012 despite little evidence supporting their use in this patient population, according to a new study in JAMA Internal Medicine.

Michael E. Johansen, MD, MS, of Ohio State University and Lee A. Green, MD, MPH, of the University of Alberta, Canada, reviewed data from the 1999–2012 Medical Expenditure Panel Survey that included 13,099 individuals over the age of 79 who were taking statins for primary or secondary prevention of vascular disease (coronary heart disease [CHD], stroke or peripheral vascular disease). The authors chose to investigate the use of statins among this population by vascular disease because the very elderly tend to have the highest rate of statin use in the United States.

Rates of vascular disease in this population increased from 27.6% in 1999–2000 to 43.7% in 2011–2012. and the rate of statin use among individuals taking them for primary prevention went up from 8.8% in 1999–2000 to 34.1% in 2011–2012. The proportion of patients taking atorvastatin peaked in 2005–2006 and then steadily declined, while the proportion taking simvastatin was steady until 2007–2008 when it started to increase. The percentage of statin users taking rosuvastatin steadily increased after its approval by the Food and Drug Administration (FDA) in 2003.

“Although the medical community has embraced the use of statins for primary prevention in the very elderly, caution should be exercised given the potential dangers of expanding marginally effective treatments to untested populations,” the authors concluded.

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