Statins and fibrates could reduce the risk of a stroke in healthy older adults by 30%, according to a new study.
The French research study, published in the BMJ this week, concluded that such a reduction ‘could have an important effect on public health in other populations’.
The researchers tracked 7,484 men and women (average age 74 years) with no known history of vascular events, such as heart attacks and strokes.
They wanted to determine the association between the use of lipid-lowering drugs (statins or fibrates) in healthy older people and the long-term risk of coronary heart disease and stroke.
As part of the observational study, face-to-face examinations took place every two years to ascertain the occurrence of any adverse cardiac event or hospital admission, and to record which lipid-lowering drug each participant had been using.
Trained nurses and psychologists also performed interviews and took various physical and cognitive measurements. Factors such as education, occupation, income and lifestyle were collected as part of each follow-up visit.
After an average follow-up time of nine years, the researchers found that the use of statins or fibrates was associated with a 34% reduced risk of stroke compared with non-users. The type of lipid-lowering drug used – statin or fibrate – did not significantly alter the result, with risk reductions of 32% and 34% respectively, compared with non-users. The risk of coronary heart disease was not significantly lowered with lipid-lowering medication.
The researchers said: ‘The risk of coronary heart disease was not lower in lipid-lowering drug users. In contrast, we observed a one-third decrease in the risk of stroke in lipid-lowering drug users compared with non-users.’
Christophe Tzourio, Professor of Epidemiology at University of Bordeaux and Inserm, said the French population has a low risk of stroke so, in populations more exposed to the risk of stroke, a one-third reduction in stroke risk ‘could have an important effect on public health’.
Graeme Hankey, professor of neurology at the University of Western Australia, said the study’s results were ‘sufficiently compelling to justify further research, testing the hypothesis that lipid lowering may be effective in the primary prevention of stroke in older people’.
He said that the decision to start statins for the primary prevention of vascular disease in people over 75 ‘continues to be based on sound clinical judgment’, after considering each patient’s predicted vascular risk with and without statins, their predicted risk of adverse effects, and the patient’s own priorities and preferences for treatment.
This comes after NICE’s decision to halve the risk threshold for the use of statins in the primary prevention of cardiovascular disease to 10%, despite calls from the BMA and other clinical experts to drop the proposal because of concerns it will lead to overtreatment.