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A 2010 review concluded that treatment without history of cardiovascular disease reduces cardiovascular events in men but not women, and provides no mortality benefit in either sex. [27] Two other meta-analyses published that year, one of which used data obtained exclusively from women, found no mortality benefit in primary prevention. [28] [29]
The findings show a decrease in mortality among people 60 years of age and older — including people over the age of 85 — who took statins. The study is published in Annals of Internal Medicine .
[5] [6] [7] The study's authors estimated that the number needed to treat with rosuvastatin to prevent one cardiovascular event was 95 over two years, extrapolated to 25 over five years. The trial was stopped early, after just 1.9 years median duration, by the study's Independent Data Monitoring Board, because the interim results met the study ...
As the event rate is higher in men than in women, the decrease in events is more easily seen in men than women. [163] In those at risk, but without a history of cardiovascular disease (primary prevention), statins decrease the risk of death and combined fatal and non-fatal cardiovascular disease. [164] The benefit, however, is small. [165]
[2] [7] Of the 4,444 people enrolled in the study, 3,617 were men and 827 women, [5] 2,223 were randomly assigned a placebo and 2,221 were given 20 to 40 mg of simvastatin daily. [1] The plan was to follow the participants for a minimum of three years or until such a time as total mortality reached 440 deaths.
When examining the cost-effectiveness of statin use in older adults, the researchers report that statins were cost-effective, with the cost per quality-adjusted life years gained below £3,502 ...
A risk exists of muscle damage (myopathy and rhabdomyolysis) with statins. Hypercholesterolemia is not a risk factor for mortality in persons older than 70 years and risks from statin drugs are more increased after age 85. [2] Fibrates are indicated for hypertriglyceridemia. Fibrates typically lower triglycerides by 20% to 50%.
In Canada, screening is recommended for men 40 and older and women 50 and older. [48] In those with normal cholesterol levels, screening is recommended once every five years. [49] Once people are on a statin further testing provides little benefit except possibly to determine compliance with treatment. [50]