Statins after 70 have long been a gray zone: most large trials enrolled younger adults, so doctors often had to extrapolate. In late August 2026, the STAREE trial, published in the New England Journal of Medicine and presented at the European Society of Cardiology congress, finally tested a statin in people aged 70 and older who had no heart disease. The headline is a 30% lower relative risk of a first major cardiovascular event. The fine print matters just as much: no measurable gain in disability-free survival, and a few more muscle, liver and blood sugar events on treatment. This article explains what was found, what it does not settle, and which routine blood tests help you and your doctor follow the treatment.
What the STAREE trial actually tested
STAREE enrolled 9,971 community-dwelling adults aged 70 or older (average age 74.7, 52% women) at general practices across Australia. None had known cardiovascular disease, diabetes or dementia. Half received atorvastatin 40 mg once daily and half an identical placebo, and they were followed for a median of 5.9 years.
Two questions were asked. First, does the statin prevent a first major cardiovascular event, meaning cardiovascular death, a nonfatal heart attack or stroke, or a procedure to reopen a coronary artery? Second, does it help people live longer without dementia or persistent physical disability?
What the results show
| Outcome | Atorvastatin | Placebo | How to read it |
|---|---|---|---|
| Major cardiovascular event | 10.9 per 1,000 person-years | 15.5 per 1,000 person-years | Hazard ratio 0.70, about 30% lower relative risk |
| Death, dementia or persistent disability | 21.6 per 1,000 person-years | 23.0 per 1,000 person-years | Hazard ratio 0.94, difference not statistically significant |
| Serious adverse events | 2.7% | 2.7% | Same overall, but muscle, liver and diabetes-related events were more common on atorvastatin |
In absolute terms, the European Society of Cardiology reports that 6.0% of treated participants had a major cardiovascular event versus 8.3% on placebo over the trial, which is roughly two fewer events per 100 people treated for nearly six years. A relative reduction can sound larger than what one person experiences, so both views are worth keeping in mind.
The second result is just as informative. Taking the statin did not measurably add years lived free of dementia or disability. The trial also excluded people with diabetes or dementia, so its findings do not automatically apply to them.
A second trial asks the opposite question
A French trial called SAGA/SITE looked at the mirror situation: what happens when people aged 75 or older who already take a statin for primary prevention stop it? Among 1,160 participants analyzed (median age 80), 7.9% of those who continued and 7.2% of those who stopped had died after three years. Stopping was statistically non-inferior for death from any cause, within the margin the researchers had set.
The trial was open-label and its main measure was death from any cause, so it says less about heart attacks and strokes. It also excluded anyone with a history of cardiovascular disease. Taken together, STAREE and SAGA/SITE point toward individualized decisions rather than a single age cutoff.
Blood tests that matter if you are over 70 and on a statin
Your doctor decides which tests you need and when. These are the ones most often discussed, and why.
| Test | Why it can be relevant |
|---|---|
| LDL cholesterol | The main target of treatment; it shows how well the medicine is working over time. |
| ALT (liver enzyme) | Statins can raise liver enzymes in a small number of people. The FDA concluded in 2012 that routine periodic monitoring is not useful, so testing is usually guided by symptoms or other risk factors. |
| CK (CPK) | Ordered mainly when muscle pain or weakness has no clear cause. A normal result does not prove that symptoms are unrelated to the statin. |
| HbA1c | Statins can slightly raise blood sugar, and diabetes-related events were more frequent in STAREE. |
| Kidney function (creatinine) | Kidney disease is listed by the Mayo Clinic among factors that raise the chance of side effects. |
| Lipoprotein(a) | An inherited risk marker that a standard cholesterol panel does not capture; it is usually measured once. |
Our guide to the lipid panel explains LDL cholesterol levels and ranges. If a liver check is ordered, this page shows how to read an ALT result.
Muscle aches are the most common complaint on statins, and our August report explains what a CK blood test really shows when statins cause muscle pain. For the basics, read our CPK creatine kinase guide.
To see how blood sugar is tracked, read our HbA1c guide to blood sugar results. The inherited marker is covered in a report that explains why lipoprotein(a) screening changed in 2026. For the bigger picture, read our full guide to high cholesterol.
Latest scientific advances
STAREE is the first large randomized trial to test a statin for primary prevention specifically in older adults, which is why it drew so much attention. Before it, advice for people over 75 rested mostly on subgroup analyses and observational studies. Those can be skewed because healthier people tend to be the ones who are prescribed, and who keep taking, a treatment.
A 2025 expert consensus from the National Lipid Association and the American Geriatrics Society reached a measured conclusion for older adults without known heart disease. Statins appear to offer benefits that outweigh typical risks such as muscle symptoms and a small rise in diabetes. Evidence on memory problems is mostly neutral. Shared decision-making is the cornerstone, and stopping treatment can be reasonable for some people with serious, life-limiting illness.
A 2026 systematic review focused on people aged 80 and older found that direct randomized evidence in that age group is still thin. Benefit looks most plausible for robust people at high cardiovascular risk who have enough life expectancy ahead of them, and much less so for frail people.
What this changes for you: age alone is not a reason to start or to stop a statin. The decision rests on your overall cardiovascular risk, your general health, what matters to you, and how well you tolerate the medicine. STAREE and SAGA/SITE give your doctor better data for that conversation; they do not replace it.
When to talk to your doctor
Do not stop a statin on your own. Contact your doctor if you notice any of the following while on treatment:
- Muscle pain or weakness with no obvious cause, especially if your urine turns dark.
- Unusual fatigue, loss of appetite, pain in the upper stomach, or yellowing of the skin or eyes.
- New confusion or memory problems. Labels list these as reported effects that are generally reversible after stopping, so they deserve a medical review.
- Unusual thirst or frequent urination, which can signal high blood sugar.
Call emergency services for chest pain, sudden weakness on one side of the body, or trouble speaking.
Glossary
- Primary prevention: treatment given to prevent a first heart attack or stroke in someone who has never had one.
- Hazard ratio: a comparison of event rates between two groups over time; 0.70 means about 30% fewer events in one group.
- Person-years: a way of counting follow-up time that adds up the time each participant spent in the study.
- Disability-free survival: staying alive without dementia and without persistent physical disability.
- Non-inferiority: a trial design that tests whether a strategy is not worse than another by more than a preset margin.
- Placebo: an inactive pill that looks identical to the medicine being tested.
FAQ
What are the most common statin side effects?
Muscle symptoms are the most frequently reported, although the Mayo Clinic notes that the true added risk compared with placebo is about 5% or less. Other effects include a small rise in blood sugar and, rarely, higher liver enzymes. Most people tolerate statins well, and a different statin or dose is sometimes an option if symptoms appear.
Should everyone over 70 start a statin after STAREE?
No. STAREE enrolled people aged 70 or older without cardiovascular disease, diabetes or dementia, and it showed fewer cardiovascular events but no gain in disability-free survival. Whether to start depends on your personal risk and preferences.
Do statins cause memory loss?
Drug labels mention reports of memory loss and confusion that are generally non-serious and reversible after stopping. The Mayo Clinic describes the evidence for a direct cause as limited, and the 2025 expert consensus found it mostly neutral. In STAREE, dementia was part of the second combined measure, which did not differ significantly between groups.
Can I stop my statin if I am over 75?
In SAGA/SITE, stopping a statin used for primary prevention was non-inferior for three-year mortality in people aged 75 or older, but the trial excluded anyone with prior cardiovascular disease. This is a decision to make with your doctor, not alone.
Which blood tests do I need on a statin?
Your doctor decides. An LDL cholesterol measurement is the usual way to follow the effect, while liver enzymes, CK and HbA1c are generally ordered when there is a reason, such as symptoms or specific risk factors.
Sources
- Zoungas S, et al. Atorvastatin, Cardiovascular Events, and Disability-free Survival in Older Adults (STAREE). New England Journal of Medicine, 2026
- Bonnet F, et al. Discontinuation of statins for primary prevention in adults aged 75 years or older (SAGA/SITE). The Lancet Healthy Longevity, 2026
- European Society of Cardiology. Cholesterol-lowering medication reduces major cardiovascular events by 30% in older people without known cardiovascular disease
- Bittner VA, et al. Managing hypercholesterolemia in adults older than 75 years without a history of atherosclerotic cardiovascular disease: an expert clinical consensus from the National Lipid Association and the American Geriatrics Society. Journal of Clinical Lipidology, 2025
- Epelde F. Statin therapy for primary prevention in adults aged 80 years and older: a systematic review. Current Neuropharmacology, 2026
- MedlinePlus (NIH). Statins
- Mayo Clinic. Statin side effects: weigh the benefits and risks
- U.S. Food and Drug Administration. Cholesterol-lowering drugs get labeling changes
Other articles
- Statin muscle pain: what your CK blood test really shows
- Lipoprotein(a) screening for every adult: what the 2026 guideline changes
- LDL cholesterol: levels, ranges, and risks
- High cholesterol: symptoms, causes, numbers, and treatment
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