Ann Geriatr Med Res.  2020 Jun;24(2):91-98. 10.4235/agmr.20.0028.

Effects of Statin Use for Primary Prevention among Adults Aged 75 Years and Older in the National Health Insurance Service Senior Cohort (2002–2015)

Affiliations
  • 1Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
  • 2College of Pharmacy, Chung-Ang University, Seoul, Korea
  • 3Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea

Abstract

Background
This study aimed to identify adverse events and mortality in adults aged 75 years and older who were initially prescribed statins for primary prevention.
Methods
This retrospective study analyzed data from the National Health Insurance Corporation–Senior Cohort from 2002¬ to 2015. An exact block matched model was constructed from statin user and statin non-user groups.
Results
The study sample comprised 1,370 older adults (mean age, 78 years), with 685 statin non-users matched to 685 new statin users. Compared to non-users, the adjusted hazard ratios (HRs) of new statin users were 0.83 (p=0.04) for all-cause mortality, 1.24 (p=0.003) for major adverse cardiovascular events, and 1.18 (p=0.06) for new-onset diabetes mellitus. In a sub-analysis of statin use duration, longer statin use (>5 years) was associated with a significantly lower risk of all-cause mortality (HR=0.76, p=0.01) but not with major adverse cardiovascular events (HR=0.88, p=0.36) or new-onset diabetes mellitus (HR=0.95, p=0.78) after adjusting for age, sex, body mass index, diabetes mellitus, hypertension, aspirin use, and antiplatelet use.
Conclusion
Our findings suggested that statins started for primary prevention in older adults aged 75 years or more had an advantageous effect on all-cause mortality only if used for at least 5 years.

Keyword

Cardiovascular diseases; Older adults; Mortality; Primary prevention; Statin
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