The use of statins in older patients has been tied to controversy and questions about the drugs’ efficacy in senior patients.
The AMDA, a professional group representing physicians who work in nursing homes, noted the issue in its list of five questionable medical tests and treatments. The list was created as part of the national “Choosing Wisely” campaign meant to alert the public about inappropriate or overused medical interventions, according to The New York Times/NewOldAge Blog. The key list item, “Don’t routinely prescribe lipid-lowering medications in individuals with a limited life expectancy,” concerns patients who are older than 70 years of age.
Dr. Hosam Kamel, an Arkansas geriatrician and vice chair of AMDA’s clinical practice committee, said there is no real scientific evidence that supports statin use in patients 70 years of age and older who do not have pre-existing cardiovascular disease, according to the Times’ blog. Just a few studies have looked at outcomes in this demographic. The majority of data on statin benefits involves larger studies that focused on people of varying ages. According to Dr. Kamel, study results have not conclusively established the benefits of statins in seniors with no cardiovascular disease.
In fact, noted Dr. Kamel, there is evidence of dangers tied to senior use of this drug class, such as muscle aches, liver toxicity, and gastrointestinal distress; increased evidence of impaired memory and increased diabetes risks; and some ties to increased cancer risks, according to the Times’ blog. “Our recommendation is that physicians weigh the potential risks and benefits and not automatically prescribe these medications,” Dr. Kamel said, regarding seniors with no diagnosed cardiovascular disease.
Dr. Rita Redberg, a cardiologist at the University of California, San Francisco, Medical Center and editor-in-chief of JAMA Internal Medicine told the Times’ blog that, “I see elderly patients every week who tell me they couldn’t get out of bed, they had terrible diarrhea, they were walking around in a fog after they started taking statins, and when they stopped the medications those feelings went away.”
Statins are considered the best selling drugs worldwide and are prescribed to people who are diagnosed with obesity, diabetes, and metabolic syndrome—a dangerous health combination that includes excess body fat and/or high blood pressure—, blood sugar, and/or high cholesterol, according to Medical News Today previously. Statins are prescribed to reduce cholesterol to prevent potentially fatal blood clots, heart attack, and stroke.
Drugs in the statin class are also known to carry increased risks for myopathy (severe muscle damage) and should be prescribed with caution and at the lowest possible effective dose to reduce risks for these side effects. Another study found that statins may minimize exercise benefits in obese adults.
Prior studies have also found that people who take statins may face increased risks for developing age-related cataracts and that the association between statins and cataracts may be the same as for Type 2 diabetes, which is a known risk factor for age-related cataracts. That finding is significant because statin use is typically greater in Type 2 diabetics when compared to the general population. An analysis of previously conducted clinical trials cast doubt on statin efficacy in the prevention of blood clots, and a prior ScienceDaily report found that 30 prior trials of statin drugs revealed that the drugs are barely effective at preventing blood clots, if at all.