For Older People, Reassuring News in the Statin Debate

There is accumulating evidence that the benefits of statins far outweigh possible risks, and nearly all statins on the market are now available as inexpensive generics.

Cholesterol-lowering statin drugs, already one of the most popular medications worldwide, may become even more widely used as evidence grows of their safety and value to the elderly and their potential benefits beyond the heart and blood vessels.

Among the latest are reports of the ability of several leading statins to reduce deaths from common cancers and blunt the decline of memory with age. Perhaps such reports will persuade a reluctant 65-year-old friend who has diabetes, and others like him, that taking the statin his doctor strongly advised is a smart choice.

In addition to accumulating evidence that the benefits of statins far outweigh possible risks for the vast majority of people for whom they are now recommended, nearly all statins on the market are now available as inexpensive generics.

Full disclosure: I have a strong family history of heart disease and have been taking a statin — atorvastatin, originally marketed as Lipitor — for many years after dietary changes failed to control a steadily rising blood level of artery-damaging LDL-cholesterol. My prescription is now fully covered by my Medicare Part D insurance with no co-pay.

But cost of a medication is not the only consideration for a drug that can be lifesaving for many people. The primary indication for taking a statin is to reduce the risk of a heart attack or stroke by lowering serum LDL-cholesterol and, in some cases, also triglycerides, both of which can damage coronary arteries when levels rise above normal.

Statins offer further cardiovascular protection by stabilizing the fatty deposits in arteries called plaque that can break loose, block a major artery and cause a heart attack or stroke.

Current guidelines typically recommend statin therapy for:

  • People with a history of heart disease, stroke or peripheral artery disease or risk factors that give them a 10 percent or greater chanceof a heart attack within 10 years;
  • People over 40 with diabetes and an LDL-cholesterol level above 70 milligrams per deciliter;
  • People over 21 with an LDL-cholesterol level of 190 or higher (despite dietary changes to minimize saturated fats and achieve a normal body weight).

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