Statins Lower Risk of Dying in Older Adults with Chronic Kidney Disease

A close up of a person's hand as they pick up a pill.
Taking statins appeared to help people even if they didn’t have high cholesterol. Grace Cary/Getty Images
  • Older adults with chronic kidney disease who took a cholesterol-lowering statin had a lower risk of dying from any cause, a new study found.
  • Participants in the study had no history of cardiovascular disease. This type of statin use is known as primary prevention.
  • Experts caution that the study mainly involved older white men, so the results may not apply to women or racial/ethnic minorities.

Statins, a class of drugs commonly used to treat high cholesterol, reduced the risk of death among older adults with chronic kidney disease but no history of atherosclerotic cardiovascular disease, a new study found.

Atherosclerotic cardiovascular disease, also known as atherosclerosis, involves the buildup of fatty deposits known as plaque on the inner walls of the arteries.

The study, published Dec. 6 in JAMA Network Open, supports previous research showing the benefits of statin use for primary prevention in people with chronic kidney disease, the researchers wrote.

Primary prevention is the use of statins in people without a history of cardiovascular disease. The United States Preventative Services Taskforce (USPSTF) recommends this approach for certain adults at higher risk of developing cardiovascular disease.

Current clinical guidelines recommend that people with moderate chronic kidney disease start treatment with statins due to their risk of atherosclerotic cardiovascular disease.

“However, the guidelines do not differentiate between primary and secondary prevention,” or those with a history of cardiovascular disease, the researchers wrote.

“This study reinforces the importance of preventive care in patients with chronic kidney disease,” said Dr. Jesse Yang, cardiologist and senior vice president of medical management with kidney-care company Somatus, who was not involved in the new study.

“Statins, along with other preventive care, work to prevent negative outcomes for these at-risk patients and help them lead healthier, longer lives,” he told Healthline.

Lower risk of dying from any cause

In the study of 14,828 people older than 65 years with chronic kidney disease, researchers found that statin use was associated with a 9% lower risk of dying from any cause.

People taking a statin also had a 4% lower risk of a major adverse cardiovascular event, such as heart attack or stroke. However, this difference was not statistically significant.

Data came from the Veterans Affairs (VA) healthcare system.

Dr. Bradley Serwer is an interventional cardiologist and chief medical officer at VitalSolution, which provides cardiovascular and anesthesiology services to hospitals.

Sewer pointed out the VA “has been a leading source of medical research for many years.”

However, participants in the study were predominantly white men with an average age of 74 years old. As a result, the results may not apply to other groups, such as women or racial and ethnic minorities, Serwer told Healthline.

In addition, “this study did not assess dose or duration of statin therapy in order to determine an optimal outcome,” he said.

And because the study is observational, it does not prove that people with chronic kidney disease who take statins live longer. “It merely shows there is an association with lower all-cause mortality in those who started a statin,” said Serwer, who was not involved in the new research.

Statins prevent cardiovascular disease

The study also did not look specifically at why people taking a statin had a lower risk of dying. But “we know from numerous other studies that statins have multiple benefits aside from merely lowering cholesterol levels,” said Serwer.

“Statin medications have the ability to reduce stroke and heart attack rates independently of lowering cholesterol,” he said. “And statins help stabilize blood vessels and help prevent plaque development and plaque rupture.”

In addition, Yang said people with chronic kidney disease have a higher risk of chronic conditions like hypertension and diabetes, which can lead to the earlier development cardiovascular disease. 

This can increase the risk of insulin resistance and dyslipidemia, or unhealthy levels of one or more kinds of fat in your blood, he said.

So “the proven effect of statins to prevent cardiovascular disease in patients with metabolic syndrome likely led to lower rates of cardiovascular events and death in study patients,” he said.

The researchers write that additional research — in particular, a randomized clinical trial — is needed to confirm their results.

However, the findings recommend against withholding or stopping statins in older patients with chronic kidney disease and no history of cardiovascular disease, they said.

Takeaway

Researchers examined data on over 14,000 older adults with chronic kidney disease and no history of cardiovascular disease. Those taking a statin, a class of drugs used to lower cholesterol, had a lower risk of dying from any cause.

Clinical guidelines recommend statin use in people with moderate chronic kidney disease due to their risk of atherosclerotic cardiovascular disease. This study reinforces the benefits of statins in this population.

Additional research is needed to confirm the results, including a randomized clinical trial. Research on a more diverse population is also needed to know if statin use benefits all groups similarly.

Leave a Comment

Your email address will not be published. Required fields are marked *