A large randomized trial has found that daily atorvastatin reduced major cardiovascular events by 30% among adults aged 70 or older who had no diagnosed cardiovascular disease, diabetes or dementia. Researchers presented the STAREE findings on Saturday at the European Society of Cardiology Congress 2026 in Munich, while the New England Journal of Medicine published the results simultaneously.
The Australian study enrolled 9,971 community-dwelling participants, with a mean age of 74.7 years and women comprising 52% of the group. Investigators randomly assigned 4,984 people to 40 milligrams of atorvastatin daily and 4,987 to a matching placebo, then followed them for a median of 5.9 years. The masked, placebo-controlled design addressed a longstanding evidence gap because adults over 70 were underrepresented in earlier prevention trials.
Major cardiovascular events, defined as cardiovascular death, nonfatal heart attack, stroke or coronary revascularization, occurred in 6.0% of atorvastatin recipients and 8.3% of placebo recipients. That corresponds to a hazard ratio of 0.70 and an absolute difference of 2.3 percentage points. The trial estimated that treating 37 people for about six years would prevent one such event.
Atorvastatin did not significantly improve the other co-primary outcome, disability-free survival. The composite of death from any cause, dementia or persistent physical disability occurred in 637 participants receiving atorvastatin and 676 receiving placebo, producing a hazard ratio of 0.94 that did not reach statistical significance. The result means the cardiovascular benefit should not be interpreted as proof of longer survival without dementia or disability.
Safety findings also require context. TCTMD reported more hepatobiliary events in the atorvastatin group, at 3.3% compared with 0.9%, and more new diabetes-related events, at 4.0% compared with 2.7%. Overall serious adverse events were not higher, but 7.2% of participants stopped their assigned regimen because of an adverse event. The participants were comparatively healthy, so the findings do not automatically extend to frail adults, people with diabetes or those already living with cardiovascular disease.
The investigators said the evidence could inform prevention guidelines and conversations between clinicians and older patients, an area where recommendations have remained uncertain. Any decision to start a statin still requires an individual assessment of absolute cardiovascular risk, other medicines, possible side effects and patient preferences; the trial does not support older people beginning or changing prescription treatment without medical advice.
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