Cardiovascular Disease

RPR Commentary: Statins taken for primary prevention in adults over 80 were associated with a reduction in 4-year mortality rates of 31%. James W. Mold, MD, MPH

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ABSTRACT Background: Evidence supporting the use of statins for primary prevention of cardiovascular disease (CVD) in individuals aged≥ 80 years remains limited. This study aimed to evaluate the long-term clinical benefits and safety of statins for primary prevention in patients aged 80 years and older. Methods: We conducted a population-based retrospective cohort study using electronic medical records and pharmacy dispensing data from Clalit Health Services in Israel, covering the period from January 2015 to December 2020. Patients aged ≥ 80 years without prior CVD who were persistent statin users were compared with similar patients not receiving statins. Exclusions included prior CVD, dialysis, or death within 1 year of follow-up. Outcomes included all-cause mortality, new coronary events, myopathy, dementia, and diabetes mellitus. Cox proportional hazards models, adjusted for potential confounders, were used to assess the association between statin use and clinical outcomes. Results: Among 15,745 patients (mean age 84.5 years; 66% female), 8413 were statin users. Over a 4-year mean follow-up, statin use was associated with a 31% reduction in mortality (HR 0.69; 95% CI: 0.34–0.74; p < 0.001) and a 20% reduction in new coronary events (HR 0.80; 95% CI: 0.68–0.94; p = 0.008). No significant differences were observed in the incidence of myopathy, diabetes, or dementia. Benefits were not observed in patients who discontinued statins before age 80. Conclusions: In patients aged ≥ 80 years, statin therapy for primary prevention was associated with reduced all-cause mortality and coronary morbidity, without increased risk of adverse events. Early discontinuation diminished these benefits.

Author/s:

Wafaa Hamodi, Ophir Lavon, Samir Kassem

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Nathan Hinkle — Mon, 09 Mar 2026 21:10:43 +0000

Date Added:

March 9, 2026

Journal/Publication:

Journal of the American Geriatrics Society

Publisher:

Wiley Periodicals LLC

Publication Date:

March 7, 2026

URL:

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1111/jgs.70375Digital Object Identifier (DOI)

Keywords

statin therapy

Geriatrics

cardiovascular disease

Adults Aged 80 years or older

MeSH

Cardiovascular Disease

Hydroxymethylglutaryl-CoA Reductase Inhibitors

follow-up studies

RPR Commentary: Statins taken for primary prevention in adults over 80 were associated with a reduction in 4-year mortality rates of 31%. James W. Mold, MD, MPH

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Author/s:

Wafaa Hamodi, Ophir Lavon, Samir Kassem

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Nathan Hinkle — Mon, 09 Mar 2026 21:10:39 +0000

Date Added:

March 9, 2026

Journal/Publication:

Journal of the American Geriatrics Society

Publisher:

Wiley Periodicals LLC

Publication Date:

March 7, 2026

URL:

Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1111/jgs.70375Digital Object Identifier (DOI)

Keywords

statin therapy

Geriatrics

cardiovascular disease

Adults Aged 80 years or older

MeSH

Cardiovascular Disease

Hydroxymethylglutaryl-CoA Reductase Inhibitors

follow-up studies

RPR Commentary: Statins taken for primary prevention in adults over 80 were associated with a reduction in 4-year mortality rates of 31%. James W. Mold, MD, MPH

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Author/s:

Wafaa Hamodi, Ophir Lavon, Samir Kassem

Chronic kidney disease

Megan George — Mon, 05 Jan 2026 14:47:36 +0000

Date Added:

January 5, 2026

Journal/Publication:

The Lancet

Publication Date:

January 3, 2026

URL:

Chronic Kidney Disease

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

Keywords

chronic kidney disease

MeSH

Cardiovascular Disease

cause of death

Renal Replacement Therapy

renal insufficiency

renal insufficiency, chronic

kidney

Renal

An update on chronic kidney disease including diagnostic categories, prognostic tools, and management strategies. James W. Mold, MD, MPH

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Globally, the prevalence of chronic kidney disease is estimated to be approximately 850 million cases, with approximately 4 million individuals needing kidney replacement therapy for kidney failure. By 2050, chronic kidney disease is projected to become the fifth leading underlying cause of death worldwide. Despite its numerous causes, chronic kidney disease can be screened for, diagnosed, and staged with simple laboratory tests. Individuals with chronic kidney disease are at increased risk of kidney failure and many other health implications. Risk of premature cardiovascular disease is particularly noteworthy, as most patients with chronic kidney disease develop a disability or die from cardiovascular disease before ever progressing to kidney failure. Since 2019, large randomised trials have identified several effective treatments that both slow progressive kidney function decline and reduce cardiovascular risk, greatly expanding available treatments for chronic kidney disease. The wide range of complications associated with chronic kidney disease means that patients encounter many different specialties. Active engagement in chronic kidney disease identification and timely initiation of cost-effective interventions by all clinicians could now substantially reduce the global burden of complications of chronic kidney disease and kidney failure.

Author/s:

William G. Herrington, Parminder K. Judge, Morgan E Grams, Christoph Wanner

Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment

Rowan Hutchins — Sat, 06 May 2023 05:00:00 +0000

Date Added:

May 6, 2023

Journal/Publication:

JAMA Intern Med

Publisher:

JAMA

Publication Date:

March 14, 2022

Issue:

Volume:

182

URL:

Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jamainternmed.2022.0134

Keywords

adult

cholesterol

stroke prevention

PMID (1):

35285850

MeSH

Cardiovascular Disease

cholesterol, LDL

Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use

myocardial infarction

The modest reduction in all-cause mortality affected by statins is largely independent of the amount of LDL cholesterol reduction suggesting a somewhat lipid independent anti-inflammatory effect. Two caveats: 1)The 0.8% absolute risk reduction is per around 3 years, so longer term treatment will have more impact; 2) absolute risk reduction is directly proportional to baseline risk, so higher risk individuals will benefit more. James W. Mold, MD, MPH.

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Importance The association between statin-induced reduction in low-density lipoprotein cholesterol (LDL-C) levels and the absolute risk reduction of individual, rather than composite, outcomes, such as all-cause mortality, myocardial infarction, or stroke, is unclear.

Objective To assess the association between absolute reductions in LDL-C levels with treatment with statin therapy and all-cause mortality, myocardial infarction, and stroke to facilitate shared decision-making between clinicians and patients and inform clinical guidelines and policy.

Data Sources PubMed and Embase were searched to identify eligible trials from January 1987 to June 2021.

Study Selection Large randomized clinical trials that examined the effectiveness of statins in reducing total mortality and cardiovascular outcomes with a planned duration of 2 or more years and that reported absolute changes in LDL-C levels. Interventions were treatment with statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) vs placebo or usual care. Participants were men and women older than 18 years.

Data Extraction and Synthesis Three independent reviewers extracted data and/or assessed the methodological quality and certainty of the evidence using the risk of bias 2 tool and Grading of Recommendations, Assessment, Development and Evaluation. Any differences in opinion were resolved by consensus. Meta-analyses and a meta-regression were undertaken.

Main Outcomes and Measures Primary outcome: all-cause mortality. Secondary outcomes: myocardial infarction, stroke.

Findings Twenty-one trials were included in the analysis. Meta-analyses showed reductions in the absolute risk of 0.8% (95% CI, 0.4%-1.2%) for all-cause mortality, 1.3% (95% CI, 0.9%-1.7%) for myocardial infarction, and 0.4% (95% CI, 0.2%-0.6%) for stroke in those randomized to treatment with statins, with associated relative risk reductions of 9% (95% CI, 5%-14%), 29% (95% CI, 22%-34%), and 14% (95% CI, 5%-22%) respectively. A meta-regression exploring the potential mediating association of the magnitude of statin-induced LDL-C reduction with outcomes was inconclusive.

Conclusions and Relevance The results of this meta-analysis suggest that the absolute risk reductions of treatment with statins in terms of all-cause mortality, myocardial infarction, and stroke are modest compared with the relative risk reductions, and the presence of significant heterogeneity reduces the certainty of the evidence. A conclusive association between absolute reductions in LDL-C levels and individual clinical outcomes was not established, and these findings underscore the importance of discussing absolute risk reductions when making informed clinical decisions with individual patients.

Author/s:

Byrne, P., Demasi, M., Jones, M.

Diagnosis and acute management of migraine

Aubrey Delammermore — Wed, 08 Feb 2023 06:00:00 +0000

Date Added:

February 8, 2023

Journal/Publication:

CMAJ

Publisher:

CMA Impact Inc

Publication Date:

January 30, 2023

Issue:

Volume:

195

Pages:

E153-E158

URL:

Diagnosis and acute management of migraine

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.211969

Keywords

PMID (1):

36717129

MeSH

Humans

Migaine Disorders* / diagnosis

Migraine disorders* / therapy

Migraine Disorders

Cardiovascular Disease

A concise review of the presumed cause and treatment of migraine headaches. James W. Mold, MD, MPH

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Migraine is a leading cause of disability across all age groups.
• Routine imaging is not recommended in patients with migraine
who have no red flags, atypical symptoms or abnormal findings
on neurologic examination.
• A stratified approach for acute migraine treatment empowers
patients to choose from different treatment options
depending on attack symptoms and severity and encourages
patients to combine medications from different classes.
• Effective acute migraine treatment includes acetaminophen,
nonsteroidal anti-inflammatory drugs and triptans.
• Ubrogepant and rimegepant are new, effective migraine
treatments, suitable for patients with cardiovascular disease in
whom triptans are contraindicated.

Author/s:

Tzankova, V., Becker, W. J., Chan, T. L. H.

Aspirin Use to Prevent Cardiovascular Disease US Preventive Services Task Force Recommendation Statement

Saige Blanchard — Tue, 10 May 2022 05:00:00 +0000

Date Added:

May 10, 2022

Journal/Publication:

Journal of the American Medical Association

Publisher:

American Medical Association

Publication Date:

April 26, 2022

Issue:

Volume:

327

Pages:

1577-1584

URL:

Aspirin Use to Prevent Cardiovascular Disease US Preventive Services Task Force Recommendation Statement

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2022.4983

Keywords

aspirin

cardiovascular disease

USPSTF

mortality

PMID (1):

35471505

MeSH

Adult

Cardiovascular Disease

incidence

Ulcer

primary prevention

Current USPSTF recommendations regarding the use of low-dose aspirin for primary prevention of adverse cardiovascular events. James W. Mold, MD, MPH

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Importance: Cardiovascular disease (CVD) is the leading cause of mortality in the US, accounting for more than 1 in 4 deaths. Each year, an estimated 605 000 people in the US have a first myocardial infarction and an estimated 610 000 experience a first stroke.

Objective: To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the effectiveness of aspirin to reduce the risk of CVD events (myocardial infarction and stroke), cardiovascular mortality, and all-cause mortality in persons without a history of CVD. The systematic review also investigated the effect of aspirin use on colorectal cancer (CRC) incidence and mortality in primary CVD prevention populations, as well as the harms (particularly bleeding) associated with aspirin use. The USPSTF also commissioned a microsimulation modeling study to assess the net balance of benefits and harms from aspirin use for primary prevention of CVD and CRC, stratified by age, sex, and CVD risk level.

Population: Adults 40 years or older without signs or symptoms of CVD or known CVD (including history of myocardial infarction or stroke) who are not at increased risk for bleeding (eg, no history of gastrointestinal ulcers, recent bleeding, other medical conditions, or use of medications that increase bleeding risk).

Evidence assessment: The USPSTF concludes with moderate certainty that aspirin use for the primary prevention of CVD events in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk has a small net benefit. The USPSTF concludes with moderate certainty that initiating aspirin use for the primary prevention of CVD events in adults 60 years or older has no net benefit.

Recommendation: The decision to initiate low-dose aspirin use for the primary prevention of CVD in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one. Evidence indicates that the net benefit of aspirin use in this group is small. Persons who are not at increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit. (C recommendation) The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults 60 years or older. (D recommendation).

Author/s:

US Preventive Services Task Force

Dietary recommendations for prevention of atherosclerosis

Saige Blanchard — Mon, 28 Feb 2022 06:00:00 +0000

Date Added:

February 28, 2022

Journal/Publication:

Cardiovascular Research

Publisher:

European Society of Cardiology

Publication Date:

July 6, 2021

Volume:

173

URL:

Dietary recommendations for prevention of atherosclerosis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1093/cvr/cvab173

Keywords

Atherosclerosis

Coronary Heart Disease

cardiovascular disease

diet

PMID (1):

34229346

MeSH

Cardiovascular Disease

A review of the current evidence regarding dietary strategies for lowering cardiovascular disease risk. James W. Mold, MD, MPH

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This review aims at summarizing updated evidence on cardiovascular disease (CVD) risk associated with consumption of specific food items to substantiate dietary strategies for atherosclerosis prevention. A systematic search on PubMed was performed to identify meta-analyses of cohort studies and RCTs with CVD outcomes. The evidence is highly concordant in showing that, for the healthy adult population, low consumption of salt and foods of animal origin, and increased intake of plant-based foods—whole grains, fruits, vegetables, legumes, and nuts—are linked with reduced atherosclerosis risk. The same applies for the replacement of butter and other animal/tropical fats with olive oil and other unsaturated-fat-rich oil. Although the literature reviewed overall endorses scientific society dietary recommendations, some relevant novelties emerge. With regard to meat, new evidence differentiates processed and red meat—both associated with increased CVD risk—from poultry, showing a neutral relationship with CVD for moderate intakes. Moreover, the preferential use of low-fat dairies in the healthy population is not supported by recent data, since both full-fat and low-fat dairies, in moderate amounts and in the context of a balanced diet, are not associated with increased CVD risk; furthermore, small quantities of cheese and regular yogurt consumption are even linked with a protective effect. Among other animal protein sources, moderate fish consumption is also supported by the latest evidence, although there might be sustainability concerns. New data endorse the replacement of most high glycemic index (GI) foods with both whole grain and low GI cereal foods. As for beverages, low consumption not only of alcohol, but also of coffee and tea is associated with a reduced atherosclerosis risk while soft drinks show a direct relationship with CVD risk. This review provides evidence-based support for promoting appropriate food choices for atherosclerosis prevention in the general population.