Millions of older, healthy Australians could soon be advised to start taking statins after landmark research found the medication reduced the risk of heart attack and stroke by 30 per cent in those over 70.
Until now, the benefits of taking the cholesterol-reducing drugs for otherwise healthy adults over 75 had been unclear. As a result, they had not been routinely prescribed as a preventive medicine for this group.
But a world-first clinical trial led by Monash University found the medication significantly reduced the risk of a major cardiovascular event in older adults who lived independently.
The findings, which were published in the prestigious New England Journal of Medicine on Saturday, also appear to dispel a persistent and false claim that statins cause dementia.
Co-author Dr Mark Nelson, a GP and adjunct professor at Monash University, said the findings would change the way doctors managed the risk of heart attack and stroke in older people.
“It is really reassuring to see that you can continue to prescribe or initiate statins in the over-70s,” he said.
“You have to make sure the benefit outweighs the harm, and that’s what we have demonstrated here.”
Statins are already one of the most commonly prescribed medications in Australia. Between 2.2 million and 2.6 million people take them daily.
They block the production of cholesterol in the liver. This lowers the amount circulating in a person’s blood, which can reduce and reverse cholesterol deposits in the arteries.
Current Australian guidelines recommend statins for anyone with established heart disease. They are also prescribed as a preventive medicine for people aged 45 to 79 who are assessed as high risk using a cardiovascular disease risk calculator.
But Professor Derek Chew, chief scientist and medical officer at the National Heart Foundation of Australia, said there had previously been a lack of robust evidence supporting the use of statins for people over 75. This is because older people had been historically overlooked in clinical trials of statins.
He said this cohort were at increased risk of suffering a heart attack or stroke due to their age.
While the public often assumes a heart attack leads to sudden death, Chew noted that most patients survive, often developing chronic conditions such as heart failure. Preventive therapies such as statins kept older adults out of hospitals and living independently, he said.
“For many people over the age of 70, it is about living well, not just about living longer. It’s about not being in hospital, not being debilitated by cardiovascular events. My patients always talk about wanting to live well.”
Chew urged older Australians to discuss their five-year cardiovascular risk with their doctor.
The decade-long trial, known as the Statins in Reducing Events in the Elderly (STAREE), involved almost 10,000 participants who either took a statin or placebo. More than 3400 Australian GPs were involved in the trial.
Older adults experienced the same cardiovascular benefits from statins – fewer heart attacks and strokes – as younger participants in previous trials.
In response to the landmark results, the National Heart Foundation of Australia is preparing to release updated clinical guidelines within the next six months to support GPs.
Richard Milton was prescribed statins in December 2024 after he suffered a heart attack following a surfing competition on Sydney’s northern beaches.
The fit and healthy 64-year-old recalled feeling strange and dissociated after the contest. The next minute, he had collapsed onto the bitumen of a nearby car park and his friend was performing CPR on him.
“It was a case of the right place, the right people,” Milton reflected. “Once the horse has bolted, it’s too late.”
Milton was taken to hospital and later told that one of the arteries in his heart was completely blocked. A stent was placed in the blocked artery, and he has made a full recovery.
The now 66-year-old welcomes the findings into statins for older Australians, and said looming changes to clinical guidelines would save lives.
He said he was pleased that the research had debunked the persistent claim that statins cause dementia, which was something he worried about before starting the medication.
The trial found no significant difference in dementia risk between the group who took a placebo and those who took statins.
“It’s reassuring,” Milton said. “I have had no side effects, my memory hasn’t changed. I see no reason not to take them.”
Every year, an estimated 21,000 older Australians experience major cardiovascular events, such as heart attack and stroke. The risk of suffering these events increases with age.
An estimated 60,000 Australians stopped or reduced their use of statins following a highly contentious two-part documentary aired on the ABC in 2013.
The documentary by ABC’s Catalyst science show questioned the link between elevated cholesterol and heart disease, suggesting that the benefits of statins were overstated and the drugs were overprescribed.
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