Should you keep taking your statin after 70 if you have never had a heart attack or stroke? On 7 November 2026, at the American Heart Association Scientific Sessions, the STREAM trial offered the strongest answer so far. Published the same day in The New England Journal of Medicine, the study found that stopping the statin was not inferior to continuing it on the main two-year measure, but that heart attacks, strokes and deaths were somewhat more common after stopping.
If you or a parent have taken a statin for years, here is what that means, what it does not mean, and which blood tests are worth following with your doctor.
What the STREAM trial tested
STREAM was a randomised trial run in Switzerland, the Netherlands and France. It enrolled more than 1,880 adults aged 70 and older who had at least two chronic conditions, no known cardiovascular disease, and at least a year on a statin for primary prevention (meaning to prevent a first event). A random draw decided whether they stopped or continued the drug. The trial was open-label, with no placebo, but experts who did not know each person's group judged the cardiovascular events. The main outcome combined non-fatal heart attack, non-fatal ischemic stroke and death, with a non-inferiority margin set in advance at 5.2 weeks of event-free survival over two years.
The results: "non-inferior," but not risk-free
According to HCPLive's report of the NEJM data, participants averaged 77.5 years old and stopping the statin stayed within the planned margin: the difference in event-free survival was about 2 weeks over two years. Looking at events, the main outcome occurred in 12.7% of people who stopped versus 9.2% of those who continued (hazard ratio 1.38). The authors estimate roughly one extra event for every 40 people who stopped for two years. No clear differences appeared in quality of life, pain, falls or sarcopenia (age-related muscle loss).
In a small subgroup of 235 people, LDL cholesterol at one year averaged about 176 mg/dL (4.55 mmol/L) after stopping versus about 99 mg/dL (2.56 mmol/L) for those who continued. HCPLive also reports that the trial's safety board advised people in the stopping group to discuss restarting with their doctor, and the authors, including Dr. Nicolas Rodondi of Bern, stress shared decision-making.
How STREAM fits with other trials
STREAM does not contradict the French SAGA/SITE trial or the Australian STAREE trial, which we covered in Statins After 70: What the STAREE Trial Found. Together they say the right choice depends on the person. STREAM's participants are the patients doctors see most often: people over 70 with several conditions. An earlier observational analysis from the Bern group had already pointed the same way, with more events, mostly non-cardiovascular deaths, in older patients who stopped a statin.
What this changes for you
- Never stop a statin on your own. STREAM is not a green light to quit; it is a tool for a conversation.
- Stopping can reasonably be discussed if you have troublesome side effects, limited life expectancy, many medicines, or different priorities.
- If you continue, a blood test confirms the treatment is working, and it stays useful even at 80.
Which tests can monitor or screen for this?
- A lipid panel with LDL cholesterol, to check the drug's effect and see the rebound after stopping.
- ApoB and lipoprotein(a), added in some cases.
- HbA1c, since nearly a third of participants had diabetes.
- Creatine kinase (CK) if you have muscle pain on a statin (see our article) and ALT if your doctor requests it.
Latest scientific advances
Researchers in Bern had already reported, in an observational analysis published in 2025, that older patients taking many medicines had more events, mainly non-cardiovascular deaths, after stopping a statin. STREAM now adds evidence from true randomisation. What remains is identifying who can stop safely, which the trial cannot yet do. In practice that means fewer decisions made by age alone and more made case by case.
When to see a doctor
Talk to your doctor if you are over 70 and wonder whether your statin is still worthwhile, or if you notice muscle pain, unusual fatigue or dark urine on treatment. Do not stop any medicine without medical advice. Call 999 or 112 right away for chest pain, sudden shortness of breath or signs of stroke (facial droop, arm weakness, trouble speaking).
Glossary
- Statin: a medicine that lowers LDL cholesterol by blocking its production in the liver.
- Primary prevention: treatment meant to prevent a first heart attack or stroke in someone who has never had one.
- Non-inferiority trial: a trial designed to show that one option (here, stopping) is not worse than the other beyond a margin set in advance.
- Multimorbidity: having two or more chronic conditions.
- Sarcopenia: gradual loss of muscle mass and strength with age.
FAQ
Can you stop statins after 70?
It is an individual decision to make with your doctor. STREAM found stopping was not inferior on its prespecified main outcome, but with somewhat more cardiovascular events and deaths in the stopping group.
What happens to cholesterol when you stop a statin?
It usually climbs back toward its pre-treatment level. In the STREAM subgroup that was measured, LDL averaged about 176 mg/dL (4.55 mmol/L) after a year off the drug.
Does STREAM apply to people who have had a heart attack?
No. It covered primary prevention only. After a heart attack or stroke, statins are generally continued.
Are side effects a reason to stop?
They can be, but a different statin, dose or schedule may be tried first. Talk to your doctor before changing anything.
Should I get my cholesterol checked after 70?
Yes, if you are on treatment or have risk factors. Your doctor sets the schedule.
Sources
- Rodondi N, Haller ML, Bardoczi JB, et al. Discontinuing statins in multimorbid older adults without cardiovascular disease (STREAM). N Engl J Med. 2026. DOI: 10.1056/NEJMoa2606634
- HCPLive. STREAM: statin discontinuation noninferior in older adults without CVD. November 7, 2026
- Aebi PS, et al. Rationale and design of STREAM: study protocol of a randomised non-inferiority clinical trial. BMJ Open. 2025. DOI: 10.1136/bmjopen-2024-093833
- ClinicalTrials.gov. STREAM, Statins in Multimorbid Older Adults Without Cardiovascular Disease, NCT05178420
- Aponte Ribero V, et al. Target trial emulation of statin discontinuation in multimorbid older adults with polypharmacy. Eur J Clin Invest. 2025. DOI: 10.1111/eci.70126
- Bonnet F, et al. Discontinuation of statins for primary prevention in adults aged 75 years or older (SAGA/SITE). Lancet Healthy Longev. 2026. DOI: 10.1016/j.lanhl.2026.100884
- Zoungas S, et al. Atorvastatin, cardiovascular events, and disability-free survival in older adults (STAREE). N Engl J Med. 2026. DOI: 10.1056/NEJMoa2607314
- MedlinePlus (NIH). Statins
Other articles
- Statins After 70: What the STAREE Trial Found
- Statin muscle pain and the CK blood test
- LDL cholesterol: calculated or measured
- LDL cholesterol: definition and levels
- The lipid panel
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