Healthy adults over 70 who took a daily statin had 30 percent fewer major cardiovascular events over roughly six years than those on placebo, according to the STAREE trial published in the New England Journal of Medicine on August 29, 2026.
The Australian study randomized 9,971 community-dwelling adults aged 70 and up with no history of cardiovascular disease, diabetes or dementia to 40 mg of atorvastatin or a placebo pill daily. Over a median follow-up of 5.9 years, 6.0 percent of the statin group had a heart attack, stroke, cardiovascular death or needed a coronary artery procedure, compared with 8.3 percent on placebo.
The finding matters because until now there was little direct evidence for starting a statin in this age group. Major US and European guidelines have stopped short of recommending routine primary-prevention statins in people over 75, and the US Preventive Services Task Force still considers the evidence insufficient in that group.
What the trial did not show
The catch is that STAREE's main endpoint was not simply hearts and strokes. The trial was designed around disability-free survival, meaning years lived without dying, developing dementia or losing physical independence. On that measure, there was no meaningful difference between the atorvastatin and placebo groups.
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Roughly 80 percent of the deaths in the trial came from non-cardiovascular causes, which the investigators say helps explain why fewer heart attacks and strokes did not translate into more years of independent living. Rates of dementia were also nearly identical, at 10.6 and 10.3 events per 1,000 person-years in the statin and placebo groups.
What healthy older adults might ask their doctor
Lead investigator Sophia Zoungas, a professor at Monash University's School of Public Health and Preventive Medicine in Melbourne, told the ESC Congress in Madrid that until STAREE reported, "there was clearly insufficient evidence to recommend statins for primary prevention in people over 70." Roughly 40 percent of the participants were aged 75 or older at enrollment, and their average LDL cholesterol was 127 mg/dL.
Discussant François Mach, a cardiologist at Geneva University Hospital, said the results should push guideline writers to act. "Age should no longer be used as a reason to withhold statin therapy for primary prevention," he said, adding that "national and international guidelines have to be adapted accordingly."
The trade-off is not free. Serious adverse events were balanced at 2.7 percent in both arms, but muscle, liver and diabetes-related side effects were more common with atorvastatin.
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Zoungas noted that "about 50 percent of the participants in our trial actually did note some form of musculoskeletal issue at baseline," which is one reason many older adults are wary of statins in the first place. Anyone in this age group considering a statin for prevention should talk it through with their doctor, weighing cardiovascular risk against these known side effects and any existing medications.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.