Pravastatin Doesn't Improve Clinical Outcomes in Seniors

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Older adults with hypertension and hyperlipidemia might not benefit from taking pravastatin for primary prevention of cardiovascular events, according to an open-label study in JAMA Internal Medicine.

The study, a secondary analysis of a large lipid-lowering trial (ALLHAT-LLT), looked at adults aged 65 and older who were clear of atherosclerotic cardiovascular disease at baseline and had moderate hyperlipidemia and hypertension. Roughly 2900 patients were randomized to pravastatin (40 mg/day) or usual care.

Over 6 years, all-cause mortality was higher with pravastatin than with usual care (19% vs. 16%), although the difference was not statistically significant. The mortality gap was wider for patients aged 75 and older (31% vs. 23%), but still didn't reach statistical significance. There were also no significant differences in secondary outcomes, including coronary heart disease events.

An editor's note concludes that statins' musculoskeletal risks and the current findings "should be considered before prescribing or continuing statins for patients in this age category."