University of Helsinki, Clinicum, and Helsinki University Hospital, Finland.
Center for Life Course Health Research, University of Oulu, Finland.
J Gerontol A Biol Sci Med Sci. 2018 Sep 11;73(10):1418-1423. doi: 10.1093/gerona/gly073.
Statin treatment is common among 80+ people, but little is known about statin effects on health-related quality of life (HRQoL) in this oldest age group.
In the Helsinki Businessmen Study (HBS), men born from 1919 to 1934 (original n = 3,490), have been followed-up since the 1960s. In 2015, a questionnaire about lifestyle, diseases, and medications, and including RAND-36/SF-36 HRQoL instrument was mailed to survivors. About 612 men (72.6%) responded, 530 of them reporting their medications (98% community-living). Propensity score analysis was used to compare statin users and nonusers for HRQoL.
We compared 229 current statin users (median age 85 years, interquartile range 84-88 years) with 301 nonusers (86; 84-89 years). Current statin users had had significantly higher serum cholesterol level in midlife (p < .001), but current lifestyle-related characteristics were similar in users and nonusers. Statin users reported more hypertension (61.1%, p < .001), diabetes (23.6%, p <.001), and atherosclerotic cardiovascular disease (ASCVD, 33.6%, p <.001), than nonusers. Statin users reported higher mean scores than nonusers in all eight RAND-36 subscales, but after adjustments for multiplicity and a propensity score we found no significant differences between statin users and nonusers. Stratification for primary (no ASCVD) and secondary (with CVD) prevention supported the main results.
Our study suggests that statin treatment has no significant effect on health-related quality of life among octogenarian, community-dwelling men. The results contradict concerns about statin treatment in the oldest-old, and may caution against deprescribing of statins due to old age alone.
在 80 岁以上的人群中，他汀类药物治疗很常见，但对于这个最年长的年龄组，他汀类药物对健康相关生活质量（HRQoL）的影响知之甚少。
在赫尔辛基商人研究（HBS）中，1919 年至 1934 年出生的男性（原始 n = 3490）自 20 世纪 60 年代以来一直被随访。2015 年，向幸存者邮寄了一份关于生活方式、疾病和药物的问卷，其中包括 RAND-36/SF-36 HRQoL 工具。约有 612 名男性（72.6%）做出回应，其中 530 名报告了他们的药物使用情况（98%居住在社区）。使用倾向评分分析比较了他汀类药物使用者和非使用者的 HRQoL。
我们比较了 229 名当前他汀类药物使用者（中位年龄 85 岁，四分位间距 84-88 岁）和 301 名非使用者（86 岁；84-89 岁）。当前的他汀类药物使用者在中年时的血清胆固醇水平明显较高（p <.001），但使用者和非使用者的当前生活方式相关特征相似。他汀类药物使用者报告的高血压（61.1%，p <.001）、糖尿病（23.6%，p <.001）和动脉粥样硬化性心血管疾病（ASCVD，33.6%，p <.001）比非使用者更多。与非使用者相比，他汀类药物使用者在所有八项 RAND-36 子量表中的平均评分均较高，但在进行多重调整和倾向评分后，我们发现他汀类药物使用者和非使用者之间没有显著差异。对一级（无 ASCVD）和二级（有 CVD）预防的分层支持了主要结果。
我们的研究表明，他汀类药物治疗对 80 岁以上、居住在社区的男性的健康相关生活质量没有显著影响。研究结果与对最年长人群中他汀类药物治疗的担忧相矛盾，并且可能警告人们不要仅仅因为年龄大而停用他汀类药物。
