Statins Extend Life for Elderly Heart

A new study has found cholesterol lowering drugs known as statins increase the life expectancy of elderly heart patients. Dr. J.L. Mehta from the University of Arkansas for Medical Sciences (UAMS) found the medications added an average of two years to the life of elderly patients with a history of heart disease as compared to non-statin users.

Nearly 1.5 million patients were tracked by Dr. Mehta as part of the study. All of these patients had sought treatment in 10 medical centers of the South Central Veterans Affairs Healthcare Network of the US Department of Veterans Affairs. The study’s results are remarkable because almost all statin users were at higher risk of death than the non-statin users.

Statins were prescribed to around 350,000 patients, nearly 50% of them above 70 years of age. The remaining 1.2 million patients were not prescribed statins. Elderly patients with a history of coronary artery disease, hypertension, diabetes, current smoking, and use of cardiovascular drugs represented most of the patients prescribed statins.

“When we performed an extensive data analysis on survival, we were surprised to find statin users actually lived an average two years longer despite the patients having more health risk factors and being older than non-statin users,” said Dr. Mehta, Director of the Division of Cardiovascular Medicine at UAMS and the Stebbins Chair in Cardiology. “We did not expect statin therapy would have such a profound impact on patients’ lives.”

Cholesterol is responsible for development of the condition called atherosclerosis in which cholesterol containing plaques form inside the arteries and shrink them to reduce blood flow. When these plaques rupture, they give rise to a blood clot, further reducing the blood flow. If in the heart, the dropping blood supply increases the strain on the heart to pump sufficient blood ultimately leading to a heart attack. If the blood clot is formed on plaques in the brain, it causes a stroke.

Statins reduce the production of cholesterol by the liver and thereby help lower the cholesterol levels in the blood. Reduction in the levels of cholesterol also reduces the formation of new plaque and on occasion, even reduces the size of existing plaques.
Beginning in 2004, the Veteran American Medical Center/UAMS study utilized the services of the VISN 16 Data Warehouse for data collection and administration. VISN 16 is a patient record system implemented in 1996 for the South Central Veterans Affairs Healthcare Network. Dr. Zoran Bursac of the Department of Biostatistics in the Fay W. Boozman College of Public Health at UAMS assisted Dr. Mehta in the data analysis.

“The study is unique because of its size and because previous statin studies generally have excluded people over age 65,” Dr. Mehta said. “It also is the first study to show a graded relationship between risk factors and the life-saving effects of statins. The greater the morbidity/mortality risk score, the greater the statins’ benefit. For example, odds of death decreased by 22 percent for statin users with a risk score of one. Those with a risk score of five or six saw their odds of death decrease by 49 percent. Risk scores were based on factors such as history of diabetes, previous heart attack, tobacco use, hypertension and age,” he added.

“We know a lot about statins, but what eventually counts is how these drugs behave in patients,” Dr. Mehta said. “These data are very powerful.”

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