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Comparison of statins for primary prevention of cardiovascular disease and persistent physical disability in older adults

Zhou, Z ORCID: 0000-0002-0835-8686, Curtis, AJ, Ernst, ME, Ryan, J, Zoungas, S, Wolfe, R, McNeil, JJ, Murray, AM, Reid, CM, Chowdhury, EK, Woods, RL, Tonkin, AM and Nelson, MR ORCID: 0000-0001-9941-7161 2021 , 'Comparison of statins for primary prevention of cardiovascular disease and persistent physical disability in older adults' , European Journal of Clinical Pharmacology , doi: 10.1007/s00228-021-03239-1.

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Abstract

Purpose: Recent epidemiological evidence has suggested that use of lipid-lowering medications, particularly statins, was associated with reduced cardiovascular disease (CVD) events and persistent physical disability in healthy older adults. However, the comparative efficacy of different statins in this group remains unclear. This study aimed to compare different forms of statins in their associations with CVD and physical disability in healthy older adults.Methods: This post hoc analysis included data from 5981 participants aged ≥ 70 years (≥ 65 if US minorities; median age:74.0) followed for a median of 4.7 years, who had no prior CVD events or physical disability and reported using a statin at baseline. The incidence of the composite and components of major adverse cardiovascular events and persistent physical disability were compared across different statins according to their type, potency, and lipophilicity using multivariable Cox proportional-hazards models.Results: Atorvastatin was the most used statin type at baseline (37.9%), followed by simvastatin (29.6%), rosuvastatin (25.5%), and other statins (7.0%, predominantly pravastatin). In comparisons of specific statins according to type and lipophilicity (lipophilic vs. hydrophilic statin), observed differences in all outcomes were small and not statistically significant (all p values > 0.05). High-potency statin use (atorvastatin and rosuvastatin) was marginally associated with lower risk of fatal CVD events compared with low-/moderate-potency statin use (hazard ratio: 0.59; 95% confidence interval: 0.35, 1.00).Conclusion: There were minimal differences in CVD outcomes and no significant difference in persistent physical disability between various forms of statins in healthy older adults. Future investigations are needed to confirm our results.

Item Type: Article
Authors/Creators:Zhou, Z and Curtis, AJ and Ernst, ME and Ryan, J and Zoungas, S and Wolfe, R and McNeil, JJ and Murray, AM and Reid, CM and Chowdhury, EK and Woods, RL and Tonkin, AM and Nelson, MR
Keywords: statin, cardiovascular disease, disability, elderly, primary prevention
Journal or Publication Title: European Journal of Clinical Pharmacology
Publisher: Springer-Verlag
ISSN: 0031-6970
DOI / ID Number: 10.1007/s00228-021-03239-1
Copyright Information:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021

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