Stopping Statins in Later Life Brought a Small Rise in Heart Events

CATEGORY: HEALTHY AGING & LONGEVITY

Quitting a long-held statin turned out to carry a measurable price. In a randomized trial of 1,880 adults aged 70 and older, all taking a statin (the standard pill for lowering LDL, the “bad” cholesterol) to prevent a first heart attack, 12.7% of those who stopped went on to have a heart attack or stroke or to die over roughly two years, against 9.2% of those who kept taking it.¹ The investigators put it plainly: about one extra event for every 40 people who stopped. The trial still counted that loss as falling inside the safety margin it had set in advance. Both halves of the result are true. Here’s how they fit together.

A Computer Split 1,880 Patients Down the Middle

The trial, called STREAM, ran at 24 sites in Switzerland, France, and the Netherlands. Everyone enrolled was 70 or older, had taken a statin for at least a year without ever having heart disease, and lived with at least two other chronic conditions. Half were told to stop their statin and any other cholesterol drug. The other half carried on as before. A computer made the split, so the two groups started out alike in everything except the pill. People knew which group they were in, but the committee judging each heart attack and stroke didn’t. The drug did what it always does: a year in, LDL cholesterol averaged 176 mg/dL among the stoppers and 99 among the continuers.¹

One Extra Event for Every 40 Who Stopped

The trial’s main yardstick was time spent free of heart attack, stroke, and death over two years. Stoppers averaged 96.5 such weeks; continuers averaged 98.5. Losing two weeks sat within the 5.2-week allowance the trialists had defined as acceptable, so stopping was formally judged “noninferior.”¹ Counting people tells it more bluntly. Events struck 119 of 938 stoppers and 87 of 942 continuers, a 38% higher relative risk. Heart attacks ran 1.4% versus 0.6% in the first two years, and strokes 1.9% versus 0.8%. Picture a full city bus of 40 riders, all quitting their statin together. Over two years, one of them has a heart attack, a stroke, or a death that the pill would likely have prevented.

The Payoff From Stopping Never Showed Up

The whole case for quitting was that fewer pills might mean fewer side effects and better daily life. That payoff didn’t appear. Quality of life, pain, falls, and muscle-loss risk all came out the same in both groups.¹ So the trade ran one way: stopping bought nothing measurable and cost a small amount of protection. After seeing the data, the trial’s own safety monitors advised that participants who’d stopped be told to speak with their physicians about restarting. The lead investigators’ reading was more measured: for most people this age without heart disease, stopping proved generally safe, but the uptick in events means no one should read the trial as a blanket green light.

A Smaller French Trial Saw No Rise in Deaths

What does the rest of the randomized evidence say? A French trial of 1,160 generally healthier adults aged 75 and older found that stopping a preventive statin didn’t raise deaths over three years: 7.2% died after stopping versus 7.9% among those who continued.² That trial was smaller and tracked only deaths, not heart attacks and strokes, which is where STREAM saw the gap open. And the drug’s value at these ages isn’t in doubt from the other direction either: a separate trial found that starting a statin after 70 cut heart attacks and strokes.³ Taken together, the trials suggest the medicine keeps working late in life, and that walking away from it costs a little more in sicker patients than in healthier ones.

Key Takeaways

• Older adults who stopped their preventive statin had more heart attacks, strokes, and deaths than those who continued: 12.7% versus 9.2% over about two years, or roughly one extra event per 40 people who stopped.
• The loss stayed inside the margin the trial had set beforehand, so stopping was formally ruled “noninferior.” The trial’s safety monitors still ended by recommending that stoppers discuss restarting with their physicians.
• The hoped-for benefits of quitting never materialized. Quality of life, pain, and falls looked the same whether people stopped or continued.
• A smaller French trial in healthier adults 75 and older saw no rise in deaths after stopping, so the cost of quitting may depend on how much other illness someone carries.

References

1. Rodondi N, Haller ML, Bardoczi JB, et al. Discontinuing statins in older adults without cardiovascular disease. New England Journal of Medicine. 2026; published online November 7, 2026:NEJMoa2606634. link
2. Bonnet F, Poulizac P, Rousselot N, et al.; SAGA/SITE Study Group. Discontinuation of statins for primary prevention of atherosclerotic cardiovascular disease in adults aged 75 years or older (SAGA/SITE): a multicentre, open-label, pragmatic, non-inferiority randomised trial. The Lancet Healthy Longevity. 2026;7(7):100884. link
3. Zoungas S, et al. Atorvastatin, cardiovascular events, and disability-free survival in older adults. New England Journal of Medicine. 2026; published online August 29, 2026:NEJMoa2607314. link