Zhen Zhou1, Andrea J Curtis2, Michael E Ernst3,4, Joanne Ryan2, Sophia Zoungas2, Rory Wolfe2, John J McNeil2, Anne M Murray5, Christopher M Reid2,6, Enayet K Chowdhury6, Robyn L Woods2, Andrew M Tonkin2, Mark R Nelson7. 1. Menzies Institute for Medical Research, University of Tasmania, TAS, 17 Liverpool Street, Hobart, 7000, Australia. zhen.zhou@utas.edu.au. 2. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 3. Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa, IA, USA. 4. Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa, IA, USA. 5. Berman Center for Outcomes and Clinical Research, Division of Geriatrics, Department of Medicine Hennepin HealthCare, Hennepin Healthcare Research Institute, University of Minnesota, Minneapolis, MN, USA. 6. School of Public Health, Curtin University, Perth, WA, Australia. 7. Menzies Institute for Medical Research, University of Tasmania, TAS, 17 Liverpool Street, Hobart, 7000, Australia.
Abstract
PURPOSE: Recent epidemiological evidence has suggested that use of lipid-lowering medications, particularly statins, was associated with reduced cardiovascular disease (CVD) events and persistent physical disability in healthy older adults. However, the comparative efficacy of different statins in this group remains unclear. This study aimed to compare different forms of statins in their associations with CVD and physical disability in healthy older adults. METHODS: This post hoc analysis included data from 5981 participants aged ≥ 70 years (≥ 65 if US minorities; median age:74.0) followed for a median of 4.7 years, who had no prior CVD events or physical disability and reported using a statin at baseline. The incidence of the composite and components of major adverse cardiovascular events and persistent physical disability were compared across different statins according to their type, potency, and lipophilicity using multivariable Cox proportional-hazards models. RESULTS: Atorvastatin was the most used statin type at baseline (37.9%), followed by simvastatin (29.6%), rosuvastatin (25.5%), and other statins (7.0%, predominantly pravastatin). In comparisons of specific statins according to type and lipophilicity (lipophilic vs. hydrophilic statin), observed differences in all outcomes were small and not statistically significant (all p values > 0.05). High-potency statin use (atorvastatin and rosuvastatin) was marginally associated with lower risk of fatal CVD events compared with low-/moderate-potency statin use (hazard ratio: 0.59; 95% confidence interval: 0.35, 1.00). CONCLUSION: There were minimal differences in CVD outcomes and no significant difference in persistent physical disability between various forms of statins in healthy older adults. Future investigations are needed to confirm our results.
PURPOSE: Recent epidemiological evidence has suggested that use of lipid-lowering medications, particularly statins, was associated with reduced cardiovascular disease (CVD) events and persistent physical disability in healthy older adults. However, the comparative efficacy of different statins in this group remains unclear. This study aimed to compare different forms of statins in their associations with CVD and physical disability in healthy older adults. METHODS: This post hoc analysis included data from 5981 participants aged ≥ 70 years (≥ 65 if US minorities; median age:74.0) followed for a median of 4.7 years, who had no prior CVD events or physical disability and reported using a statin at baseline. The incidence of the composite and components of major adverse cardiovascular events and persistent physical disability were compared across different statins according to their type, potency, and lipophilicity using multivariable Cox proportional-hazards models. RESULTS: Atorvastatin was the most used statin type at baseline (37.9%), followed by simvastatin (29.6%), rosuvastatin (25.5%), and other statins (7.0%, predominantly pravastatin). In comparisons of specific statins according to type and lipophilicity (lipophilic vs. hydrophilic statin), observed differences in all outcomes were small and not statistically significant (all p values > 0.05). High-potency statin use (atorvastatin and rosuvastatin) was marginally associated with lower risk of fatal CVD events compared with low-/moderate-potency statin use (hazard ratio: 0.59; 95% confidence interval: 0.35, 1.00). CONCLUSION: There were minimal differences in CVD outcomes and no significant difference in persistent physical disability between various forms of statins in healthy older adults. Future investigations are needed to confirm our results.
Authors: Zhen Zhou; Richard Ofori-Asenso; Andrea J Curtis; Monique Breslin; Rory Wolfe; John J McNeil; Anne M Murray; Michael E Ernst; Christopher M Reid; Jessica E Lockery; Robyn L Woods; Andrew M Tonkin; Mark R Nelson Journal: J Am Coll Cardiol Date: 2020-07-07 Impact factor: 24.094
Authors: Wei-Hsuan Lo-Ciganic; Robert M Boudreau; Shelly L Gray; Janice C Zgibor; Julie M Donohue; Subashan Perera; Anne B Newman; Eleanor M Simonsick; Douglas C Bauer; Suzanne Satterfield; Joseph T Hanlon Journal: Ann Pharmacother Date: 2013-06-18 Impact factor: 3.154