How many years can statin therapy add to a person's life?

From the Guidelines

Statin therapy can add approximately 2-3 years to a person's life for high-risk individuals, though the benefit varies based on individual risk factors. For those with established cardiovascular disease or at high risk, statins like atorvastatin (20-80mg daily), rosuvastatin (10-40mg daily), or simvastatin (20-40mg daily) provide the greatest benefit when taken consistently over many years 1. The life extension is most significant for those who start treatment earlier and maintain it long-term. Statins work by lowering LDL cholesterol, reducing inflammation in blood vessels, and stabilizing arterial plaques, which collectively decrease the risk of heart attacks and strokes.

The benefit accumulates over time, with minimal gains in the first year but increasing advantages over decades of use. Side effects like muscle pain occur in about 5-10% of users, but for most high-risk patients, the life-extending benefits substantially outweigh potential risks. It is essential to consider individual risk factors, such as diabetes, hypertension, and smoking, when assessing the potential benefits of statin therapy 1.

Some key points to consider when prescribing statins include:

• Starting with moderate-intensity statin therapy for patients with diabetes aged 40-75 years without ASCVD 1
• Using high-intensity statin therapy for patients with diabetes aged 40-75 years at higher cardiovascular risk 1
• Considering the addition of ezetimibe or a PCSK9 inhibitor to maximum tolerated statin therapy for patients with multiple additional ASCVD risk factors and an LDL cholesterol ≥70 mg/dL (≥1.8 mmol/L) 1
• Continuing statin treatment in adults with diabetes aged >75 years already on statin therapy 1

Overall, the decision to initiate statin therapy should be based on a thorough assessment of individual risk factors and a discussion of the potential benefits and risks with the patient.

From the Research

Statin Therapy and Life Expectancy

• The provided studies do not directly address the question of how many years statin therapy can add to a person's life 2, 3, 4, 5, 6.
• However, one study suggests that statins may help prevent a first major adverse cardiovascular event (MACE) in adults aged 50-75 years old if they have a life expectancy of at least 2.5 years 4.
• Another study found that treating 100 adults without known cardiovascular disease with a statin for 2.5 years prevented 1 MACE in 1 adult, but there is no evidence of a mortality benefit 4.
• The other studies discuss the benefits and risks of statin therapy in different age groups and populations, but do not provide direct evidence on the impact of statins on life expectancy 2, 3, 5, 6.

Benefits of Statin Therapy

• Statins have been shown to reduce the risk of atherosclerotic cardiovascular disease (ASCVD) events in various populations 2, 3, 5, 6.
• Adding ezetimibe or PCSK9 inhibitors to statin therapy can further reduce the risk of ASCVD events in adults with very high or high cardiovascular risk 3.
• Statins may also help stabilize or regress atherosclerotic plaque, leading to a reduction in ASCVD events 6.

Limitations and Uncertainties

• There is a lack of direct evidence on the impact of statin therapy on life expectancy 2, 3, 4, 5, 6.
• The decision to use statin therapy should be made on a case-by-case basis, taking into account individual risk factors and potential benefits and harms 4, 5, 6.