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A new randomized trial suggests some people aged 70 and older may pause cholesterol-lowering treatment without large short-term harm — but the data also raise caution about longer-term risks. Presented at the American Heart Association meeting and published in The New England Journal of Medicine, the study offers fresh evidence that could change conversations between clinicians and older patients about keeping or stopping statins.
Study design and headline finding
Researchers enrolled 1,880 adults aged 70 and up who were taking statins to prevent their first heart attack or stroke. All participants had at least two chronic conditions but no prior cardiovascular disease. Half were randomized to stop statins; the other half continued the medication.
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Over a typical follow-up of about two years — with some people observed for as long as four years — the group that discontinued treatment experienced a higher rate of the combined outcome of heart attack, ischemic stroke or death than those who kept taking statins. Roughly 13% of people who stopped had one of these events versus about 9% who continued.
What the numbers mean
The difference met the trial’s pre-defined criteria for being small enough to consider stopping in some patients, but it was not zero — and it prompted the study’s safety board to tell participants who had stopped to talk with their clinicians about restarting therapy.
Study authors and outside cardiologists stressed nuance: the modest increase in events does not support a blanket recommendation to stop statins across this age group, but it also shows that discontinuation may be reasonable for some individuals after shared decision-making.
Other outcomes and patient experience
Investigators looked beyond heart attacks and strokes. They found no meaningful differences between groups in measures such as reported quality of life, muscle pain, number of falls or decline in muscle mass and strength during the trial period.
That result addresses a common concern among older adults — that continuing statins will worsen muscle symptoms or daily functioning — and in this trial continuing treatment did not appear to increase those problems.
| Outcome | Stopped statin | Continued statin |
|---|---|---|
| Composite: heart attack, ischemic stroke, or death | 13% | 9% |
| Quality of life, muscle pain, falls, muscle strength | No meaningful difference | No meaningful difference |
| Nonadherence to assigned strategy | Some resumed statins | Some discontinued |
Limitations to keep in mind
The trial has several important caveats. About 14% of participants did not follow their assigned strategy, blurring the contrast between groups. The study only included people without prior cardiovascular events, so the findings do not apply to secondary prevention.
Follow-up was relatively short for a condition managed over decades: most participants were observed for roughly two years. That leaves unanswered questions about the long-term consequences of stopping statins for a healthy 70‑year‑old who may live for many more years.
How clinicians and patients might use this information
This evidence tightens but does not close the window on individualized deprescribing of statins in older adults. Clinicians and patients should weigh overall health, life expectancy, competing medications and patient priorities.
- For patients with side effects or a high medication burden: stopping may be a reasonable option after a careful discussion with a clinician.
- For otherwise healthy older adults with long expected lifespan: continuing treatment may better preserve long-term cardiovascular protection.
- Shared decision-making: the trial supports tailoring the choice rather than making a one-size-fits-all call.
Lead investigators noted that additional follow-up would help clarify whether the small excess in events seen when statins were stopped grows or shrinks over time. Until then, the results provide a timely, evidence-based touchpoint for clinicians and older patients deciding whether to keep taking a widely prescribed preventative medication.
