Tasmanian-led clinical research is exploring how cholesterol-lowering drugs might prevent heart attacks and strokes in the elderly, but more evidence is needed about the possible side effects.
Cholesterol-lowering drugs, known as statins, are often recommended for people at risk of cardiovascular disease.
However, there is still a level of clinical uncertainty regarding the benefits and harms of prescribing statins in otherwise healthy patients over the age of 70.
Published in the Journal of American College of Cardiology this week, Statins in Reducing Events in the Elderly, or STAREE, is a clinical trial being led by Monash University and Tasmania's Menzies Institute for Medical Research.
So far more than 800 Tasmanians are participating.
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It will use data from a previous trial - Aspirin in Reducing Events in the Elderly, or ASPREE - to explore how statin use may be beneficial for preventing cardiovascular disease, but not for preventing death, disability or dementia.
More than 19,000 patients aged over 70 with no known cardiovascular disease, dementia or significant physical disability were enrolled in the international ASPREE trial between 2010 and 2014.
Compared with those who weren't, the 31 per cent of participants who reported statin use at the start of the study were found to have fewer heart attacks and strokes (4.6 percent verse 3.3 per cent) and persistent physical disability (2.2 per cent verse to 1.9 per cent) over an average of 4.7 years.
In contrast, no differences were seen for deaths, dementia and cancer events, nor for the length of disability-free life.
ASPREE chief investigator and study co-author Professor Mark Nelson said the data had enabled researchers to investigate a range of factors that may affect healthy older adults.
"GPs have a dilemma. As their patient gets older, their risk of heart and stroke gets higher. Should they give them medications such as statins to protect them even if they have no symptoms of disease," he said.
"There is a paucity of clinical trials in the elderly to indicate what is the best thing to do."
Tasmania has the country's highest rate of heart disease, with a quarter of the population estimated to be living with cardiovascular disease.
While observational, lead author Dr Zhen Zhou of Menzies said the findings underscore the importance of an ongoing randomised controlled trials, with ASPREE findings suggesting statin therapy might have varying benefits on different health outcomes in healthy older people.
"In the absence of evidence, these findings support the current clinical practice guidelines that statin therapy in the healthy elderly needs to be considered on an individualised basis," she said.
"The Australian STAREE study led by Monash University, the world's largest primary prevention trial of statins in the elderly, should inform clinicians on whether giving daily doses of a statin to healthy elderly Australians will help them live longer and healthier."
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