For older adults who take statins to prevent a first heart attack or stroke but have not yet had one, stopping the medication may be a reasonable option—at least in the short term—according to preliminary late-breaking research presented at the American Heart Association's Scientific Sessions 2026. The study, which included nearly 1,900 adults ages 70 and older with at least two chronic health conditions, found that those who discontinued statins had similar rates of heart attack, stroke, and death after two years compared to those who continued. However, an extended follow-up of up to four years revealed a small but significant increase in cardiovascular events among those who stopped the medication.
About 25% of U.S. adults have high low-density lipoprotein-cholesterol (LDL-C), or “bad cholesterol,” which can build up in arteries and increase the risk of heart attack and stroke. Statin therapy is the foundation of lipid-lowering and risk reduction, as detailed in the Association's 2026 joint guideline on dyslipidemia. Yet, recent studies have questioned the benefits of continuing statins in later life. “Whether it is safe to discontinue statins to prevent a first CVD event in the elderly remained unclear and the question we explored in our study,” said study author Rita F. Redberg, M.D., M.Sc., FAHA, professor of cardiology at the University of California, San Francisco School of Medicine.
The trial, conducted at 24 clinical centers in Switzerland, France, and the Netherlands from November 2021 to April 2026, randomized 938 participants to discontinue statins and 942 to continue. At about two years, there was no significant difference in heart attack, stroke, or death between the groups, nor were there differences in quality of life, muscle pain, falls, or sarcopenia. Statistically, for every 40 individuals who discontinued statins over two years, one additional cardiovascular event occurred. In the follow-up period of up to four years, 12.7% of those who discontinued statins experienced a heart attack, stroke, or death, compared to 9.2% of those who continued.
Redberg noted that the increased risk at four years was a new finding, possibly because this trial had more participants and longer follow-up than previous studies. “This small, increased risk of cardiovascular events means that one cannot make a general recommendation about stopping statins in this patient population,” she said. “There should be shared decision-making between the patient and the healthcare professional to know if it is appropriate for an individual to discontinue the medication. In general, however, discontinuation is safe for most people who are in this age group and without a previous CVD event.”
The findings have important implications for clinical practice. As the population ages and more older adults live with multiple chronic conditions, decisions about statin use for primary prevention require careful consideration. The American Heart Association provides resources such as Cholesterol-Lowering Medications and the Life’s Essential 8™ - How to Control Cholesterol Fact Sheet to help patients and clinicians weigh the risks and benefits. The study's limitations include crossover between groups, with about 14% of participants switching, though additional analyses yielded consistent results.
For more information on cholesterol management, visit heart.org and stroke.org.
