Over 40 Adults and Preventive Statins

The U.S. Preventive Services Task Force (USPSTF) recommends adults as young as 40 to consider taking a low to a moderate-dose statin for the prevention of cardiovascular disease (CVD) events or mortality, even without a history of CVD. Statins are drugs that lower the amount of cholesterol circulating in the blood. Currently, in the United States, seven statin drugs are available. Statin drugs can lower the risk of CVD for those between the age of 40 and 75, having at least one risk factor for CVD, and a ten percent or greater risk of a heart attack or stroke over a ten-year period. Risk factors for CVD include diabetes, hypertension, smoking, or dyslipidemia. Identification of dyslipidemia and calculation of ten-year CVD event risk requires universal lipids screening in adults aged 40 to 75 years. 

The recommendation on the use of statins is based on analyses of existing data from 18 randomized controlled trials, which compare statin use among people without previous heart attacks and strokes to people taking dummy pills or nothing at all. Adults using statin had a 17% reduced risk of death from any cause and a 36% reduced risk of death from CVD compared to adults not using statin drugs. Also, according to the data adults taking statins were 37% less likely to have heart attacks, 28% less likely to have strokes, and 31% less likely to have other cardiovascular problems. 

The USPSTF recommendations are in line with prevention guidelines released by the American Heart Associate (AHA) and the American College of Cardiology (ACC) in 2013. 

The guidelines by AHA and ACC recommend people taking cholesterol-lowering statin drugs who have a 7.5% or higher risk for a heart attack or stroke within the next ten years. Changes in recommendations have been made over the years. In 2002, the recommendation was for people's risk exceeding 20% in a 10-year period. Also, it was only considered a person's risk for heart disease, stroke was not included. 

AHA and ACC provide information about which groups exceed the 7.5% risk threshold and therefore benefit from statin therapy.