Study examines stopping statins in older adults
A randomized study presented alongside the American Heart Association Scientific Sessions 2026 examined whether older adults without known cardiovascular disease could discontinue statins and other lipid-lowering therapies used for primary prevention.
The analysis, published online Nov. 7 in the New England Journal of Medicine, included 1,880 participants aged 70 and older. All had at least two chronic conditions and no known cardiovascular disease. Participants were randomly assigned either to stop statin therapy and other lipid-lowering treatments or to continue them.
The study addresses a difficult clinical question. Statins are commonly used to lower cardiovascular risk, but decisions about continuing preventive medicines can become more complex as people age and accumulate other health conditions. The trial did not establish that everyone in this population should stop treatment. Rather, it compared the outcomes of two treatment approaches over a defined follow-up period.
Primary result met the study’s noninferiority test
Researchers assessed the time to a first cardiovascular event. On the primary measure, the between-group difference in restricted mean event-free survival time at two years was minus 2.0 weeks, with a result reported as meeting the study’s noninferiority criterion.
Noninferiority does not mean the two options are identical or that discontinuation is superior. It means the investigators’ prespecified analysis found that stopping treatment was not worse than continuing it by more than the trial’s allowed margin on its primary endpoint.
That statistical result must be read alongside the trial’s event counts. During a median follow-up of 103 weeks, 12.7% of participants in the discontinuation group experienced a nonfatal heart attack, nonfatal ischemic stroke or death from any cause. The corresponding figure was 9.2% among participants who continued therapy.
The source report also noted serious adverse events in both groups: 43.0% of those who discontinued treatment experienced at least one serious adverse event, compared with 39.8% of those who continued. The supplied report does not attribute those adverse events to statin use or discontinuation, so the figures should not be treated as evidence of a particular cause.
A result that does not support a blanket rule
Rita F. Redberg, a study co-author at the University of California, San Francisco, said the small increase in cardiovascular events meant that a general recommendation to stop statins could not be made for this patient population.
Her conclusion reflects the central tension in the findings. The primary analysis supported noninferiority, yet the group that stopped treatment had a higher proportion of the combined outcome events during follow-up. The study therefore offers evidence relevant to individualized decisions, not a simple directive for all older statin users.
The participant group is also important. The trial involved people aged 70 and older who had at least two chronic conditions but no known cardiovascular disease. Its results do not automatically apply to younger people, to patients with a history of heart attack or stroke, or to people taking statins for reasons other than the primary-prevention setting described in the study.
Shared decision-making remains central
Redberg said decisions about discontinuing treatment should be made through shared decision-making between a patient and a health care professional. That approach allows the trial’s group-level findings to be considered with an individual’s medical history, treatment goals and circumstances.
For patients, the study is a reason to discuss an existing prescription rather than independently changing it. The research compared two assigned strategies under trial conditions and tracked specific outcomes over a median of roughly two years. It does not replace a personal assessment of cardiovascular risk or medication management.
For clinicians and researchers, the trial adds evidence to a field where preventive therapy in older populations has often required balancing potential benefits with the realities of multiple chronic conditions and long medication lists. It also illustrates why a single headline result can be incomplete: noninferiority on the primary endpoint and a higher observed proportion of cardiovascular events can coexist.
What the findings add
The study provides a randomized comparison of continuation and discontinuation in a clearly defined population. Its findings suggest that stopping statins may be a reasonable subject for individualized discussion among some older adults without known cardiovascular disease, while also underscoring that discontinuation was associated with more combined cardiovascular events in the reported follow-up.
The appropriate takeaway is caution and context. The evidence does not support a universal instruction to continue or stop therapy for every older adult. It supports informed conversations in which patients and clinicians weigh the measured outcomes, the person’s history and the reasons the medicine was prescribed.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
