U.K. Geriatrician: Statins, Antihypertensives “Greatly” Overprescribed for Adults 80 and Older

February 27th, 2014

U.K. Geriatrician: Statins, Antihypertensives “Greatly” Overprescribed for Adults 80 and Older

Nicholas Downing, MD

“The data strongly suggest that we are over-treating many healthy patients aged 80+ regarding stroke prevention,” concludes U.K. geriatrician Kit Byatt in a perspective published in Evidence-Based Medicine.

Byatt offers a brief review of the evidence, noting that the large HYVET study in China and Europe showed only modest stroke-prevention benefits with antihypertensive therapy in those aged 80 and older. Similarly, the PROSPER trial, a large study of pravastatin in patients aged 70 to 82 in Europe, failed to find a significant stroke-prevention benefit with treatment. Byatt also notes that morbidity associated with statins may be underestimated

He writes: “We need actively to rethink our priorities and beliefs about stroke prevention, actively informing and involving the views of the key person, the patient. Most of the patients will probably eschew the modest potential benefit, preferring the reduced burden of polypharmacy and side effects judged as ‘minor’ by the prescriber.”

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February 27th, 2014