A modeling study suggests that statins are cost-effective for the primary prevention of cardiovascular disease in older patients, but even small increases in geriatric-specific adverse effects could offset the cardiovascular benefit. The article is published in Annals of Internal Medicine.

Clinical guidelines vary on the use of statins in patients over the age of 75 due to uncertainty about the balance between the benefits and risks for adverse events such as myalgia, fatigue, reduced levels of physical activity, and cognitive impairment. Using information from clinical trials, researchers created a computer simulation to forecast the population benefit and cost-effectiveness of statins in persons aged 75 and older without a history of cardiovascular disease. The models suggest that statins are cost-effective and could help to prevent a significant number of myocardial infarction and coronary heart disease deaths in adults aged 75 to 94. However, even a small increased risk for functional limitation or cognitive impairment could offset the cardiovascular benefit.

Study: Cost-Effectiveness and Population Impact of Statins for Primary Prevention in Adults Aged 75 Years or Older in the United States, M.C. Odden, M.J. Pletcher, P.G. Coxson, D. Thekkethala, D. Guzman, D. Heller, L. Goldman, and K. Bibbins-Domingo, Annals of Internal Medicine, doi: 10.7326/M14-1430, published 20 April 2015.