Cholesterol drugs may curb strokes among low-risk older adults

Cholesterol-lowering drugs such as statins may reduce the risk of stroke in low-risk elderly patients, a French study suggests.

People who took statins or fibrates, another type of cholesterol-lowering medicine, were 34 per cent less likely to have a stroke than those who didn't, researchers report.

"If confirmed, these results are compatible with the view of keeping elderly individuals on lipid-lowering drugs for longer periods of time," senior study author Christophe Tzourio, an epidemiology professor at the National Institute of Health and Medical Research and the University of Bordeaux in France, said by email.

Millions of people worldwide take statins to help reduce their blood levels of low-density lipoprotein, known as bad cholesterol because it builds up in blood vessels and can lead to atherosclerosis, clots and heart attacks.

Unless patients have damaged arteries, many doctors recommend against statin use for people over 75 because the benefits are less clear for the elderly and the pills have been linked to side effects including diabetes, cognitive impairment, and liver injury.

Because statins are still widely used among the older patients, Tzourio and colleagues set out to see if they could shed light on the potential benefits of treatment later in life.

They analysed data from interviews with 7,500 elderly residents of three French cities starting in 1999. At the start of the study, participants were at least 65 years old, with an average age of 74. They had no history of vascular disease or stroke.

About 27 per cent of the people in the study took either statins or fibrates to lower cholesterol. These participants were more likely to be female, younger and less educated.

During an average follow up of about nine years, 292 people had a stroke and 440 experienced other cardiovascular events. Strokes were more common among men and participants who were older or had other risk factors such as diabetes, obesity or high blood pressure.

Taking cholesterol pills didn't lower the risk of vascular events or heart disease, but it did lower the odds of a stroke and death from all causes.

The study doesn't prove the pills prevent strokes, the researchers acknowledge in the British Medical Journal. Participants in the study were richer, better educated and followed healthier diets than the typical French person, the authors note.

It's possible that factors other than the drugs helped lower the risk of strokes, said Dr. Francine Welty, a cardiologist at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston who wasn't involved in the study.

While the current study focused on healthier elderly people who had no prior strokes, it's possible that the findings might be similar for people who've already had at least one stroke, Welty said in an email. Previous research in younger adults has shown statins may prevent a repeat stroke, she said.

"I would expect a similar reduction in older adults because their risk for recurrent stroke may be even higher," said Welty. "However, until a randomized trial is done in older adults, we don't know for sure."