Table 2.

Meta-Analyses of Randomized Trials of Statins for Primary Prevention in Older Adults

Study	Studies, n	Participants	Follow-Up, Years	Age Criterion, Years	Mean Age, Years	CVD Outcome	Non-CVD outcome
Savarese et al.13	7 RCTs, placebo vs statin, 1 open label	N=24,674 without atherosclerotic CVD; 43% female	3.5	≥65	73	- 1.2% ARR in MI (NNT=84) - 0.7% ARR in stroke (NNT=143) - No significantly lower CVD mortality	No significant difference in all-cause mortality
Teng et al.14	8 RCTs, statin vs placebo or usual care’	N=25,952 (n=12,974 statin, 12,978 placebo)	3.5	>65	72.7	- Major adverse cardiovascular events (RR=0.82) -MI (RR=0.74) -Non-fatal MI (RR=0.75) -No significant difference in fatal MI or stroke	No significant difference in all-cause mortality or significant adverse events, including myalgia, transaminitis, and new-onset DM
Ridker et al.15	2 RCTs, rosuvastatin vs placebo	N=8,781	Median: JUPITER, 1.8 HOPE-3, 5.6	≥70	JUPITER, median 66 HOPE-3, mean 65.7	-Nonfatal MI, nonfatal ischemic stroke and CV death, HR=0.74, 95% CI=0.61–0.91	JUPITER: DM: rosuvastatin, n=270, 3%; placebo, n=216, 2.4%; HR=1.25, 95% CI=1.05–1.49, P=.01. In those with DM risk factors who were taking rosuvastatin, 134 vascular events or deaths were prevented at the cost of 54 new cases of DM. Progression to DM in those taking rosuvastatin occurred ≈ 5.4 weeks earlier than with placebo. HOPE-3: muscle pain or weakness: rosuvastatin, n=367, 5.8%; placebo, n=296, 4.7%, P=.005; no significant difference in withdrawals because of muscle symptoms (rosuvastatin, n=83, 1.3%; placebo, n=76, 1.2%, P=.63); rhabdomyolysis or myopathy (rosuvastatin, n=2; placebo, n=1), cancer (rosuvastatin, n=267; placebo, n=286); cataract surgery (rosuvastatin, n=241, 3.8%; placebo, n=194, 3.1%, P=.02)17

RCT=randomized controlled trial; CVD = cardiovascular disease; ARR=absolute risk reduction; NNT=number needed to treat; MI=myocardial infarction; RR=relative risk; HR=hazard ratio; CI=confidence interval; DM=diabetes mellitus.