First Major Trial Shows Statins Cut Heart Risk by 30% in Adults Over 70

A world-first randomised controlled trial led by Monash University has found that daily statin therapy reduces the risk of a first major cardiovascular event by 30% in adults aged over 70, with a low risk of serious side effects. The results, published in the New England Journal of Medicine and presented at the European Society of Cardiology Congress in Germany, come from the STAREE trial — a double-blind, placebo-controlled study enrolling nearly 10,000 participants aged 70 and older. (The Guardian, 29 August 2026)

Led by Adjunct Prof Sophia Zoungas, with co-author Adjunct Prof Mark Nelson of the Monash University School of Public Health and Preventive Medicine, STAREE enrolled participants with the help of almost 3,400 GPs across Australia. The study population had a mean age of approximately 75 years and was almost exclusively white — a demographic limitation worth noting when applying the findings to broader, more diverse populations. The trial's protocol, published in 2023, set out to determine whether statins can prevent a first heart attack or stroke in older people, prevent dementia, or are otherwise useful in this age group. (Monash University, STAREE)

Statins are cholesterol-lowering medications that work by blocking an enzyme in the liver responsible for producing cholesterol. By reducing low-density lipoprotein (LDL) cholesterol — often called "bad" cholesterol — statins help prevent the buildup of fatty deposits in artery walls that can lead to heart attacks and strokes.

The number needed to treat is striking: one major cardiac event — a heart attack, stroke, or heart surgery — could be prevented for every 37 older adults treated with daily statins over a follow-up period of nearly six years. In plain terms, if you treat 37 people in their mid-70s with a statin every day for roughly six years, one of them avoids a serious heart event who otherwise would not have. That figure sits comfortably within a range clinicians would consider meaningful for primary prevention (preventing a first event in people who have never had one) in an ageing population.

STAREE fills a gap that has persisted in cardiovascular medicine for years. While the Cholesterol Treatment Trialists' Collaboration showed in a 2019 meta-analysis (a study combining data from multiple trials) that statin therapy reduces major vascular events across all age groups, including those over 75, direct randomised evidence in the over-70 cohort has been thin. The same year, a Lancet meta-analysis by J Armitage found significant reductions in major vascular events irrespective of age — roughly a fifth per 1.0 mmol/L reduction in LDL cholesterol over 4.9 years of follow-up — but explicitly noted less direct evidence of benefit among older people. (CTTC, February 2019; The Lancet)

Prior observational and retrospective data pointed in the same direction. A September 2024 study concluded that most people over 70 should consider taking statins, describing the treatment as cost-effective and linked to better health outcomes in older age while cutting heart disease and stroke risk. A retrospective study reported by NEJM Journal Watch found that initiating statins in older patients was associated with lower mortality during seven years of follow-up. And evidence published in The Lancet Healthy Longevity suggests the time to benefit for statins may be as short as 2.5 years — potentially even shorter in older adults. (The Guardian, September 2024; NEJM Journal Watch; The Lancet Healthy Longevity)

The trial's design was rigorous. Earlier Monash work had calculated that 28 people with existing heart disease or a prior stroke would need statin treatment for five years to prevent a major event — a secondary-prevention figure (preventing a further event in people who already have heart disease) that contextualises the higher number needed to treat (37 over nearly six years) in STAREE's primary-prevention setting. The Heart Protection Study had previously confirmed statin safety in 20,000 patients aged 40–80, though most participants were under 70. STAREE extends that safety profile specifically into the older demographic. (Monash University, 2017; Monash University, STAREE)

The broader context here is one of accumulating, converging evidence. A 2025 study published in The Lancet Healthy Longevity evaluated statin effectiveness and safety for primary cardiovascular prevention in older people. The ALLHAT-LLT randomised clinical trial, also published in The Lancet Healthy Longevity, examined statin treatment versus usual care for primary cardiovascular prevention among older adults. A separate September 2025 study found statins cut heart attack and stroke risk by more than one-third in women with inflammation who lacked conventional risk factors. The wider statin and lipid-lowering literature — including trials of rosuvastatin showing 45% reductions in cardiovascular events in women over less than two years, and combination statin-ezetimibe regimens achieving LDL targets below 70 — has long pointed to substantial benefit across patient subgroups. (The Lancet Healthy Longevity; The Lancet Healthy Longevity, ALLHAT-LLT; Reuters, September 2025; Reuters, 2009)

What STAREE adds is the kind of direct, age-specific, randomised evidence that guideline committees have been waiting for. The 30% relative risk reduction in first major cardiovascular events, combined with a low serious-side-effect profile and a number needed to treat of 37, gives clinicians and policymakers a concrete evidence base for extending statin therapy into primary prevention for the over-70 population.

There are caveats worth weighing. The trial's near-exclusive white enrollment is a real constraint on how broadly these results can be applied to other racial and ethnic groups. And whether the dementia-prevention arm of STAREE's objectives yields positive results remains a separate, still-unanswered question. But for the cardiovascular endpoint, the evidence gap in older adults has now narrowed substantially.