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Daily Dose: Late Start for Statins Still a Win?
A daily dose of clinical news on Patient Care you may have missed.
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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
On August 1, 2023 we reported on a study published in Annals of Internal Medicine that investigated the association between age and LDL-C reduction by statins.
The study
Researchers conducted a nationwide, register-based cohort study among persons in Denmark between 2008 and 2018. The cohort included 82 958 participants who received simvastatin or atorvastatin, who had LDL-C levels measured before and during statin use, according to the study abstract. Among the study cohort, 10 388 (13%) of participants were aged ≥75 years.
The main outcomes were statin response—defined for the purpose of the study as the percentage reduction in prestatin LDL-C level—and percentage reduction differences (PRDs) according to age and simvastatin or atorvastatin dose based on a longitudinal model for LDL-C.
The findings
Results showed that participants aged ≥75 years experienced greater reductions in LDL-C levels compared to those aged ≤50 years:
39% vs 33.8% for those who received simvastatin 20 mg
44.2% vs 40.2% for those who received atorvastatin 20 mg
Investigators noted the adjusted PRD for adults aged ≥75 years compared to those aged ≤50 years was 2.62 percentage points. This association, they added, was consistent for primary prevention (2.54 percentage points) and secondary prevention (2.32 percentage points) but smaller for those who initiated high-intensity statins (atorvastatin 40 mg: 1.36 percentage points; atorvastatin 80 mg: −0.58 percentage point).
Authors' commentary
"Low- to moderate-intensity statins were associated with a greater reduction in LDL-C levels in older persons than younger persons and may be more appealing as initial treatment in older adults who are at increased risk for adverse events."
Click here for more details.
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