Meta-analysis of Usefulness of Treatment of Hypercholesterolemia with Statins For Primary Prevention in Patients Older Than 75 Years

Abstract Clinical guidelines from the US and Europe do not recommend treatment with statins for primary prevention in persons with hypercholesterolemia who are older than 75 years. Data from 35 randomized controlled trials in this age group where statin therapy for primary prevention was compared to placebo or usual care were analyzed. Using all-cause death as the outcome we performed two types of analyses: frequentist and Bayesian. Frequentist analysis indicated no significant difference in mortality between cases (on statins) and controls (on placebo or usual care, p=0.16). However, in the Bayesian analysis, persons >75 years had lower mortality from treatment with statins (p=0.03). In conclusion, Bayesian analysis indicates a definite, statistically significant and clinically relevant benefit of statin treatment for primary prevention in persons >75 years of age.