Is it better not to treat vulnerable elderly people with cholesterol-lowering statins after a stroke or TIA? With a ZonMw grant of 1.5 million euros, researchers from Amsterdam UMC will work with a national consortium to investigate this question. "We expect that the benefits of treatment with statins do not outweigh the side effects and costs," says APH researcher and geriatrician Nathalie van der Velde. In The Netherlands about 40,000 people a year suffer a stroke, and 60,000 people suffer a TIA. About 40 percent of them are older than 75.

Side effects

To reduce the risk of recurrence of this type of vascular disease, cholesterol-lowering drugs (statins) are prescribed. Neurology professor and principal investigator of the study on treating vulnerable elderly with statins, Renske van den Berg-Vos: "In young people, it has been proven that these statins can prevent a new stroke or cerebral infarct. But whether this also applies to vulnerable elderly patients is unknown. Current guidelines are conflicting."

It is important to note that the reasons why people have a stroke or TIA change with age. The risk factors that play a role in younger patients with cardiovascular disease, such as high cholesterol and sometimes arteriosclerosis, can be very different in older people. In the elderly, the cause of a stroke or TIA is more often in the heart and life expectancy is shorter. And so it is unclear whether statins do anything against arteriosclerosis.

"In addition, these medications can have unpleasant side effects," says internist geriatrics Majon Muller, who is also involved in the study. A common side effect is muscle pain or muscle cramps, which affects the mobility of the elderly. Dizziness, palpitations and gastrointestinal problems are also common, in addition to interactions with medications a person is already taking.

The study

This is reason enough to study whether the quality of life of vulnerable elderly people improves when they do not take statins after a stroke or TIA. Two different groups of patients will take part in the study: elderly people who were already taking a statin (and who will stop taking one during the study) and elderly people who were not yet taking a cholesterol-lowering medicine when they suffered a stroke or TIA. In total, the researchers want to include about 1,200 patients in the study, which will last a total of 6 years.

Read more about this study on the Amsterdam UMC website. [DUTCH}