French trial: stopping statins at 75 didn't raise deaths
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- The Lancet Healthy Longevity trial randomized 1,160 French patients averaging age 80 to stop or continue statins and tracked them for three years, finding 7.2% mortality in the discontinuation group versus 7.9% in the continuation group — not statistically different
- Discontinuation still spiked LDL cholesterol by roughly 50% within three months (from 115 to 171 mg/dL), yet major cardiovascular events, heart attacks, strokes, and quality-of-life measures stayed the same between the two arms
- The participants were unusually healthy, with mortality rates half France's national average of 15%, and co-author Fabrice Bonnet of Bordeaux University Hospital stressed the findings cannot be generalized to sicker populations or those at higher cardiovascular risk
- The results clash with 2021 cohort studies from Denmark and Italy showing roughly 30% higher cardiovascular risk after statin discontinuation, but the Lancet authors argue those observational studies lacked randomization and didn't account for why patients stopped taking the drugs
- Statins lower heart attack and stroke risk by about 25% since their 1987 introduction, but the Yale commentary accompanying the study warned that "deprescribing should not be confused with therapeutic nihilism"
- American Heart Association's Donald Lloyd-Jones said statin decisions should remain individualized based on expected longevity, comorbidities, and patient preferences, while Mass General Brigham cardiologist Romit Bhattacharya said the trial gives clinicians "a little bit of permission and greater flexibility" for patients with limited life expectancy
Why it matters: For relatively healthy patients over 75 — who in this trial had mortality rates half France's national norm — the data gives doctors evidence to deprescribe statins after individualized conversations without measurable harm over three years, though the population's exceptional health sharply limits how broadly the findings apply. The conflict with 2021 Denmark and Italy observational data also underscores that randomized trials carry more weight when assessing medication discontinuation than cohort comparisons prone to selection bias.
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