“Should I be on a statin?”
Doctors hear that question often. For older patients with no existing heart disease, the answer is not simple. Most research on statins—drugs used by millions to lower cholesterol—has focused on middle-aged people, not the elderly.
Now, a major statin study focused on older people is underway. And 50 VA medical centers are taking part.
Dr. Jeffrey Whittle, a Milwaukee VA internal medicine physician-researcher, and Dr. Jacob Joseph, a cardiac specialist and researcher with the Boston VA Healthcare System, are both lead investigators on the PREVENTABLE study. The clinical trial aims to answer whether one statin in particular—atorvastatin, sold as Lipitor—can help older adults stay healthy longer.
Preventing dementia, disability, heart disease
Specifically, PREVENTABLE is looking at whether the medication can help adults aged 75 and over who do not have cardiovascular disease live better by preventing dementia, disability and heart disease. The study is funded by the National Institutes of Health and involves 100 health systems in all, including VA.
With the large number of sites and a plan to include 20,000 participants age 75 and up, the study will be among the largest ever in older adults.
Veterans and others who are 75 or older, don’t currently take a statin, and don’t have dementia, a significant disability or heart disease may be eligible to enroll. The PREVENTABLE website can help people decide if participating is right for them. On the site, a few participants share why they enrolled. One of them, 95-year-old Veteran and retired physician Murray Heimberg, says, “Studies aren’t often focused on older adults, but PREVENTABLE looks specifically at people over 75.” It’s important to note that the study will randomly assign some volunteers to receive the study drug, while others will get a placebo.
VA’s Joseph says the study is “a unique opportunity to leave a legacy for medical science and fellow older adults.” Whittle praises the Veterans who are joining: “Hats off to… Veterans who have already put their lives on the line and now continue to serve by contributing to research that can have important benefits to society.”
Importance of minority participation
Both doctors stress the importance of minority participation. Whittle recognizes that some people are hesitant to participate in medical trials based on historical wrongs. He says it is crucial, however, to learn how statins affect diverse groups, including people of color, who have often been underrepresented in clinical studies.
“There could be substantial differences in health effects for people of color, based on biology or experiences,” says Whittle. “It would be tragic if past injustices result in inadequate care because of a continuing lack of evidence in particular groups.”
He adds, “Right now, we don’t have a medicine we know prevents dementia… but it would be wonderful if we find statins could have this type of health benefit.”
Tamar Nordenberg is a freelance writer supporting the VA Office of Research and Development.