The benefits of statins for secondary prevention, that being preventing a second heart attack or stroke, are well established. However, in older adults there is the lingering question of whether statins are beneficial in primary prevention, preventing that first stroke. In a study published by C. Hjalmarsson, et al. in The American Journal of Geriatric Pharmacotherapy, study findings may have shed some light on the subject.
The authors studied older adults, average age 78, who were treated with statins to measure the beneficial effects in stroke prevention, survival and functional outcomes. The results showed that statins did not decrease stroke severity and did not improve 30-day survival. However, use of statins after that first stroke did improve survival at 12 months, along with improving function at the 12 month interval. The authors stated a limitation of their study, one being that the use of statins may have been a marker of disease severity hence outcomes were poorer. Also found in this study was that people with poorly controlled diabetes treated with statins had more long term benefits. Lastly, statin use did not influence the rate of recurrent stroke during the first year of follow-up.
These findings suggest that statin use after the first stroke may be beneficial in the long term, but the question remains as to whether preventing that first stroke with the use of statins has strong enough evidence to make general recommendations. Regardless, in all cases, the patient and the physician should make an informed decision as to whether the addition of a statin to other interventions, whether they be dietary, exercise, blood pressure treatment, etc., would be beneficial in preventing the effects from one of the most disabling events an older adult can experience.