Effects of Statin Use for Primary Prevention among Adults Aged 75 Years and Older in the National Health Insurance Service Senior Cohort (2002–2015)

• Main Authors: Sunyoung Kim, Hangseok Choi, Chang Won Won
• Format: Article
• Language: English
• Published: Korea Geriatrics Society 2020-06-01
• Series: Annals of Geriatric Medicine and Research
• Subjects: aged; cardiovascular disease; hydroxymethylglutaryl-coa reductase inhibitors; mortality; primary prevention
• Online Access: http://www.e-agmr.org/upload/pdf/agmr-20-0028.pdf
• ISSN: 2508-4798; 2508-4909

Background This study aimed to identify adverse events and mortality in adults aged 75 years and older who were initially prescribed statins for primary prevention. Methods This retrospective study analyzed the data from the National Health Insurance Corporation–Senior Cohort from 2002 to 2015. An exact block matched model was constructed from statin user and statin non-user groups. Results The study sample comprised 1,370 older adults (mean age, 78 years), with 685 statin non-users matched to 685 new statin users. Compared to non-users, the adjusted hazard ratios (HRs) of new statin users were 0.83 (p=0.04) for all-cause mortality, 1.24 (p=0.03) for major adverse cardiovascular events, and 1.18 (p=0.06) for new-onset diabetes mellitus. In a sub-analysis of statin use duration, longer statin use (>5 years) was associated with a significantly lower risk of all-cause mortality (HR=0.76, p=0.01) but not with major adverse cardiovascular events (HR=0.88, p=0.36) or new-onset diabetes mellitus (HR=0.95, p=0.78) after adjusting for age, sex, body mass index, diabetes mellitus, hypertension, aspirin use, and antiplatelet use. Conclusion Our findings suggested that statins started for primary prevention in older adults aged 75 years and older had an advantageous effect on all-cause mortality only if used for at least 5 years.