BARCELONA, Spain — If you’re thinking that your prescription for cholesterol-lowering statins is just a temporary situation, think again. A new study finds patients with heart problems who stop taking statins are putting themselves at greater risk for a heart attack or stroke.
Researchers found that people in their 40s should start taking statins if they are at risk from heart problems. Anyone with existing heart disease, no matter what age, should also begin taking the cholesterol-lowering treatment. However, once patients start taking this medication, results show it’s more harmful to stop later on.
The research team from Queen Mary University of London looked at the effects of treatment with a standard 40mg daily dose of statin. They estimated the effect of therapy versus no therapy in three scenarios: lifelong therapy, therapy which stopped when people turned 80, and therapy which began five years late among patients under 45.
The team measured the benefit of statins in quality-adjusted life years (QALYs), which is the length of life adjusted by health to reflect quality of life. One QALY is equal to one year of life in perfect health.
Benefits were also reported separately according to baseline cardiovascular risk, which refers to the likelihood of having a heart attack or stroke in the next 10 years. This risk is based on age, blood pressure, cholesterol levels, smoking status, and medical conditions.
Stopping statin therapy during old age wipes out most of their benefit
The team found a large part of the QALYs gained with statin therapy occurred later in life. The higher someone’s risk from heart problems over 10 years, the bigger and earlier the gains from statins were.
Stopping therapy at the age of 80 erased much of the benefit from the fat-busting drugs, particularly among people at relatively low risk from heart conditions. People who began taking statins at 50 and quit by 80 lost 73 percent of the benefit in QALYs if they were at low risk and 36 percent of the benefit in QALYs if they were at high risk of heart problems.
The team notes the surprising finding is explainable by the fact that people at high-risk start taking the drugs earlier, ensuring they feel more of the benefits. Women’s risk of heart conditions was lower than men’s, which means women are more likely than men to suffer if the therapy ends too early.
People under 45 with a high risk of heart problems lost seven percent of their potential QALY benefit from taking statins if they started the treatment five years too late. People under 45 at a lower risk lost two percent of the potential benefit from statins.
Heart disease is the world’s biggest killer and cause of poor health. Doctors consider high cholesterol a modifiable risk factor that people can change through their behavior and by using medication. There is strong evidence that cutting cholesterol with statins can slash the risk of coronary heart disease and stroke by roughly 25 percent.
Millions of people worldwide take statins
Statins are the most commonly used fat-busting drug, and estimates show that more than 145 million people were taking this drug in 2018 alone. The research team notes that exaggerated claims about their side-effects may mean not enough people at risk of heart problems are taking them. It’s also unclear exactly when in life is the best time to start taking statins and how long people should keep taking them for.
For the study, the researchers used computer models to estimate how beneficial statins are for people of different ages when they began taking them. The team used data on 118,000 people who took part in large international statin trials from Cholesterol Treatment Trialists’ (CTT) Collaboration and 500,000 British residents in the UK Biobank.
The model used individual characteristics such as age, sex, and disease history to simulate people’s annual risk from heart attacks, strokes, diabetes, cancer, vascular (blood vessel) death, nonvascular death, and needing coronary revascularization — a treatment which can restore blood flow to blocked veins and arteries.
“The study indicates that people in their 40s with a high likelihood of developing cardiovascular disease, and people of all ages with existing heart disease, should be considered for immediate initiation of cholesterol lowering treatment. Stopping treatment, unless advised by a doctor, does not appear to be a wise choice,” says study lead author Dr. Runguo Wu from Queen Mary University of London in a media release.
“This is because people at higher cardiovascular risk start to accrue benefit early on and have more to lose by delaying statin therapy than those at low risk.”
The team is presenting their findings at the European Society of Cardiology Congress 2022.
South West News Service writer Gwyn Wright contributed to this report.