Drop in LDL cholesterol greater with low-, moderate-intensity statins for seniors

For older versus younger adults, low- to moderate-intensity statins are associated with a greater reduction in low-density lipoprotein cholesterol (LDL-C), according to a study published online Aug. 1 in the Annals of Internal Medicine.

Giulia Corn, Ph.D., from the Danish Cancer Society Research Center in Copenhagen, and colleagues examined the association between age and LDL-C reduction by statins in a nationwide, register-based cohort study in Denmark from 2008 to 2018. Data were included for 83,958 simvastatin or atorvastatin initiators with LDL-C measurements before and during statin use (12 percent aged 75 years or older).

The researchers found that initiators aged 75 years or older had a higher mean LDL-C percentage reduction than those aged younger than 50 years with low- to moderate-intensity statins (39.0 versus 33.8 percent for simvastatin 20 mg and 44.2 versus 40.2 percent for atorvastatin 20 mg).

The adjusted percentage reduction difference was 2.62 points for initiators aged 75 years compared with those aged 50 years. This association was consistent for primary and secondary prevention (2.54 and 2.32 percentage points, respectively), but was small with high-intensity statin initiation (1.36 and −0.58 percentage points for atorvastatin 40 mg and 80 mg, respectively).

"In conclusion, low- to moderate-intensity statin therapy is associated with a greater LDL-C reduction in older than younger persons and may be more appealing as initial treatment in older adults who are at increased risk for adverse events," the authors write.

One author disclosed financial ties to Boehringer Ingelheim.

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