French trial: stopping statins after 75 doesn't raise deaths
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- The Lancet Healthy Longevity study of 1,160 French patients averaging age 80 found no significant difference in deaths (7.2% in the discontinuation group vs. 7.9% in the continuation group) or major cardiovascular events over three years.
- Study co-author Fabrice Bonnet of Bordeaux University Hospital said cholesterol is no longer a high cardiovascular risk at 75 when patients also have diabetes or hypertension, and that clinicians can be "reassuring" about stopping statins for concerned elderly patients.
- The discontinuation group saw LDL cholesterol jump 50% higher after three months (from 115 to 171 mg/dL), yet this produced no rise in heart attacks, strokes, or quality-of-life declines over the study period.
- The French authors argue that 2021 cohort studies from Denmark and Italy—which found about 30% higher cardiovascular risk after statin discontinuation—missed a critical variable (why patients stopped taking the drugs), since they compared two non-randomized cohorts rather than randomly assigning treatment.
- Cardiologist Romit Bhattacharya of Mass General Brigham said the trial gives clinicians "a little bit of permission and greater flexibility and choice" for healthy older patients with short life horizons, though he stressed it won't change treatment for most American patients over 75.
- Former American Heart Association president Donald Lloyd-Jones said statin decisions should be individualized based on expected longevity, comorbidities, and patient preferences, citing recent joint AHA guidelines.
- Statins' documented side effects include muscle pain in roughly 1% of users and small blood sugar increases that may push prediabetic patients toward type 2 diabetes, though a recent review found 62 of 66 side effects listed on package inserts don't hold up to scrutiny.
Why it matters: For millions of older patients on statins for primary prevention, this randomized trial is the first rigorous evidence that discontinuation after 75 may be safe in low-risk individuals—potentially reducing pill burden and side effects where the cholesterol-cardiovascular link weakens with age. The narrow study population (France has the lowest cardiovascular mortality among high-income countries) limits how far the results generalize to sicker American patients.
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