More than one-third of older adults receive statins despite not having vascular disease

More than one-third of adults older than 79 years old used statins in 2011 to 2012 for primary prevention, a statistically significant increase from fewer than 10 percent in 1999 to 2000, according to a survey of community-dwelling U.S. adults.

Researchers Michael E. Johansen, MD, MS, of Ohio State University, and Lee A. Green, MD, MPH, of the University of Alberta in Canada, published the results online in JAMA Internal Medicine on Aug. 24.

They noted that the increased use of statins was not based on the Adult Treatment Panel III guideline, which did not include a clear recommendation for usage in individuals older than 79.

“Although the medical community has embraced the use of statins for primary prevention in the very elderly, caution should be exercised given the potential dangers of expanding marginally effective treatments to untested populations,” the researchers wrote.

They evaluated data from the Medical Expenditure Panel Survey, which is sponsored by the Agency of Healthcare Research and Quality and the Centers for Disease Control and Prevention.

The 13,099 participants in the survey were older than 79 and did not have liver disease. They were interviewed five times during a two-year period and self-reported their demographics, medical conditions and prescription drug usage.

The rate of statin use for primary prevention increased from 8.8 percent in 1999 to 2000 to 34.1 percent in 2011 to 2012, while the rate of statin use for secondary prevention increased from approximately 25 percent to 50 percent during that same time period.

The researchers defined primary prevention as people without vascular disease, which includes coronary heart disease, stroke and peripheral vascular disease. However, they noted that the classification of vascular disease changed during the years and likely became more conservative, which they considered a potential limitation of the study. The secondary prevention group included people who had vascular disease and took statins.

The proportion of people receiving atorvastatin peaked in 2005 to 2006 before steadily declining, the proportion of people using simvastatin remained consistent until 2007 to 2008 before beginning to increase and the proportion of people using rosuvastatin steadily increased after its FDA approval in 2003.