How useful are statins in the elderly?
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- Answered 30 May 2019 Conflict of interest declaration: None BMJ Evidence-Based Medicine published, in this year, a Verdict “Absolute effects of statins in the elderly” (https://ebm.bmj.com/content/early/2019/05/15/bmjebm-2019-111189) where they reviewed a recent systematic review that appeared in the Lancet. They reported: “In participants over 75 without vascular disease, statins do not appear to reduce major vascular events: NNT 446 (NNH 223 to NNT 132), vascular death or death from any cause. In participants over 75 with vascular disease, the NNT to reduce one major vascular event is 98 (NNT 54 to 735) and for all-cause mortality is a non-significant: NNT of 216 (NNH 505 to NNT 101).” They also report: “Limitations in the study revealed there is a paucity of information on the mortality effects of statins in those at low risk of vascular disease. Evidence on harms including muscle pains and quality of life is also lacking. The latter is particularly crucial given there are no apparent mortality effects. While statins are generally safe, advancing age is associated with increased risks of adverse effects, particularly in women.”
- Answered 15 Jun 2019 Conflict of interest declaration: None I would answer this question with a question (as opposed to evidence) - Do you as a prescriber take a holistic view of the patient as opposed to using risk charts (which will put all the very elderly at high risk of most things?