World-first trial shows statins cut heart attack, stroke risk by 30% in over-70s

For a decade, researchers at Monash University tracked nearly 10,000 people over 70, half of them taking a statin and half taking a placebo, to answer a question that had lingered in medicine for years: does cholesterol-lowering medication actually work when you start it late in life? The answer, published this month in the New England Journal of Medicine and presented at the European Society of Cardiology Congress, is a clear yes. Statins reduced the risk of a first major heart attack or stroke by 30 percent among independently living older adults.

The trial, called STAREE (Statins in Reducing Events in the Elderly), fills a genuine gap in medical knowledge. Statins have been prescribed for decades to manage cholesterol and prevent cardiovascular disease, but the evidence base for starting them in people over 70 was thin. Most earlier studies had focused on younger patients or on people who had already experienced a heart attack or stroke. No one had run a large, rigorous trial to see whether giving statins to healthy older people—people without prior cardiovascular events—would actually prevent those events from happening in the first place.

The scale of the trial underscores its significance. More than 3,400 general practitioners across Australia enrolled participants in what became one of the largest cardiovascular disease prevention studies ever conducted in older populations. The researchers followed their cohort for ten years, long enough to see real clinical outcomes, not just changes in cholesterol numbers on a lab report.

The context makes the finding urgent. Around 21,000 older Australians experience a major cardiovascular event—a heart attack, a stroke, or similar event—each year. The risk climbs steeply after age 70, regardless of how well someone eats or how much they exercise. Everyone in that age bracket enters a high-risk category simply by virtue of their years. For older people and their families, that reality can feel like a sentence with no reprieve.

Adjunct Professor Sophia Zoungas, who led the research at the Monash School of Public Health and Preventive Medicine, said the results could reshape how doctors approach cardiovascular risk in aging patients. She emphasized that the trial provides what clinicians have lacked: strong, direct evidence. "Knowing there is a safe and effective measure for lowering that risk will be a huge reassurance to older people and their families," she said. The next step, she and her colleagues hope, is updated clinical guidelines that help GPs translate this evidence into practice.

Co-author Professor Mark Nelson stressed that the trial gives general practitioners the information they need to make informed decisions about individual patients. Each older person's situation is different, and a conversation between patient and doctor about whether statins make sense remains essential. Professor Derek Chew, chief scientific and medical officer at the National Heart Foundation of Australia, which helped fund the work, welcomed the findings as confirmation that statins can prevent cardiovascular events even when treatment begins much later in life.

The researchers were careful to note that people should not start, stop, or change any cholesterol medication on their own. The decision belongs in a conversation with a GP, who can weigh the evidence against a person's individual health profile, other medications, and preferences. But for the first time, that conversation can be grounded in robust evidence that statins work in older age—not just in theory, but in practice, across thousands of real patients over a full decade.