Background: Evidence on statin use for primary prevention of
cardiovascular disease (CVD) in older people needs to be extended and updated,
aiming to provide further guidance for clinical practice. Methods:
PubMed, EMBASE, Cochrane Library and Web of Science were searched for eligible
observational studies comparing statin use vs. no-statin use for primary
prevention of CVD in older people (age 65 years). The primary outcomes
were all-cause mortality, CVD mortality, coronary heart disease (CHD)/myocardial
infraction (MI), stroke and total CV events. Risk estimates of each relevant
outcome were synthesized as a hazard ratio (HR) with 95% confidence interval
(95% CI) using in the random-effects model. Results: Twelve eligible
observational studies (n = 1,627,434) were enrolled. The pooled results suggested
that statin use was associated with a significantly decreased risk of all-cause
mortality (HR: 0.54, 95% CI: 0.46–0.63), CVD mortality (HR: 0.51, 95% CI:
0.39–0.65), CHD/MI (HR: 0.83, 95% CI: 0.69–1.00), stroke (HR: 0.79, 95% CI:
0.68–0.92) and total CV events (HR: 0.75, 95% CI: 0.66–0.85). The association
in all-cause mortality still remained obvious at higher ages (70 years
old, HR: 0.56, 95% CI: 0.44–0.71; 75 years old, HR: 0.70, 95% CI:
0.60–0.80; 85 years old, HR: 0.85, 95% CI: 0.74–0.97), 20%
(HR: 0.47, 95% CI: 0.35–0.62) and 20% diabetic populations (HR: 0.50, 95%
CI: 0.40–0.64), and 50% (HR: 0.68, 95% CI: 0.59–0.79) and 50%
hypertensive populations (HR: 0.38, 95% CI: 0.16–0.88). Conclusions:
Statin use was related to a 46%, 49%, 17%, 21% and 25% risk reduction on
all-cause mortality, CVD mortality, CHD/MI, stroke and total CV events in older
patients, respectively. The significant association was also addressed in older
patients and 75 years old individuals for CVD primary prevention.
