Statins Cut Heart Attacks and Strokes 30% in Healthy People Over 70, Ten-Year Trial Finds

For decades doctors had a real gap in their knowledge: nobody had run a proper trial testing whether statins actually help healthy people over 70 who'd never had a heart attack or stroke. The STAREE trial filled that gap.

The STAREE trial, led by Professor Sophia Zoungas at Monash University's School of Public Health and Preventive Medicine, tracked 9,971 Australians aged 70 and older for a median of 5.9 years. Half got daily atorvastatin, 40 mg. Half got a placebo. Neither the participants nor their doctors knew which. The results were presented Saturday, August 29, at the European Society of Cardiology's 2026 congress in Munich and published simultaneously in the New England Journal of Medicine.

The numbers are straightforward. Major cardiovascular events, meaning cardiovascular death, nonfatal heart attack, stroke, or coronary revascularization, hit 8.3% of the placebo group versus 6.0% of the statin group. That's a 30% relative risk reduction, according to the European Society of Cardiology. Translated into practical terms by The Guardian, one major cardiac event gets prevented for every 37 older adults treated with a daily statin over roughly six years.

Safety held up too. Serious adverse events occurred at an identical rate, 2.7%, in both groups, according to MedPage Today and the European Society of Cardiology's own release. Muscle, liver, and diabetes-related side effects were somewhat more common in the atorvastatin group, but none of it moved the needle on serious harm.

What it didn't do

Statins did not significantly improve the combined measure of staying alive, dementia-free, and disability-free. That composite hit 13.6% in the placebo group and 12.8% in the statin group, a difference the researchers said wasn't statistically meaningful, according to the European Society of Cardiology.

The study authors, cited by the American College of Cardiology, offered a plausible explanation: 80% of the deaths in the trial had nothing to do with the heart. You can prevent someone's heart attack and still not add disability-free years to their life if something else gets them first. At 74 (the study's average age), cardiovascular risk is one of many things competing for the final say.

The dementia question

One persistent claim floating around wellness circles and social media is that statins cause cognitive decline or dementia. The Age and Sydney Morning Herald both reported that STAREE's findings "appear to dispel" that claim, since dementia rates didn't rise in the treatment group. STAREE was designed primarily to measure cardiovascular outcomes, not built from the ground up as a dementia study, so the evidence on this point is indirect.

Why the age gap existed in the first place

Adjunct Professor Mark Nelson, a GP and co-author on the study, explained the historical blind spot to The Guardian: statin research forty years ago focused on middle-aged smokers because that's where heart disease was concentrated. Older adults got left out, partly because they're more likely to be on multiple medications already, making trials riskier to run and harder to interpret.

Professor Derek Chew, chief scientist at the National Heart Foundation of Australia, told The Age and Sydney Morning Herald that this evidence gap wasn't a matter of doctors withholding treatment out of caution alone. It reflected an actual absence of data on whether the benefit outweighed the risk in this specific population. Now there's data.

What changes next

Current Australian guidelines already recommend statins for people 45 to 79 assessed as high-risk, and for anyone with existing heart disease regardless of age. What STAREE adds is evidence for prescribing statins as primary prevention in otherwise healthy people over 70, a group current guidelines treat cautiously. In the U.S., moderate-intensity statin therapy for the oldest adults currently carries only a weak "class IIb" recommendation in this year's American lipid guidelines, according to MedPage Today. Zoungas said she hopes STAREE prompts an update to those guidelines.

Statins are already among the most prescribed drugs in Australia, taken daily by between 2.2 and 2.6 million people, according to The Age. If guidelines shift, millions more people over 70 could be candidates.

A separate warning worth noting

Unrelated to STAREE, a separate study presented at the same ESC congress raised a different flag: researchers at Charité University Hospital in Berlin found that people with the highest blood levels of the artificial sweetener xylitol, used in jam, gum and toothpaste, had a 57% higher rate of major cardiovascular events over six years compared to those with the lowest levels, according to The Independent. Xylitol is found in some products at up to 1,000 times natural levels. Dr. Marco Witkowski, who presented the findings, called the results a reason for "further studies," not proof of causation, and noted xylitol is currently classified as safe by regulators.

The question STAREE leaves open is what happens at the prescribing desk. Guidelines take time to update, and doctors will now have to weigh a clear cardiovascular benefit against a null result on overall disability-free survival when deciding whether a healthy 72-year-old with no heart history needs to start a daily pill.