PREVENTION: Edited by Martin Bødtker MortensenPrimary prevention statin therapy in older adultsNanna, Michael G.a; Abdullah, Ahmeda; Mortensen, Martin B.b; Navar, Ann Mariec Author Information aSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA bDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark cDivision of Cardiology, UT Southwestern Medical Center, Dallas, Texas, USA Correspondence to Michael G. Nanna, MD, MHS, Yale New Haven Hospital, 20 York Street, New Haven, CT 06510, USA. E-mail: [email protected] Current Opinion in Cardiology 38(1):p 11-20, January 2023. | DOI: 10.1097/HCO.0000000000001003 Buy Metrics Abstract Purpose of review The purpose of this review is to assess the evidence for primary prevention statin treatment in older adults, within the context of the most recent guideline recommendations, while also highlighting important considerations for shared decision-making. Recent findings As the average lifespan increases and the older adult population grows, the opportunity for prevention of morbidity and mortality from cardiovascular disease is magnified. Randomized trials and meta-analyses have demonstrated a clear benefit for primary prevention statin use through age 75, with uncertainty beyond that age. Despite these data supporting their use, current guidelines conflict in their statin treatment recommendations in those aged 70–75 years. Reflecting the paucity of evidence, the same guidelines are equivocal around primary prevention statins in those beyond age 75. Two large ongoing randomized trials (STAREE and PREVENTABLE) will provide additional insights into the treatment benefits and risks of primary prevention statins in the older adult population. In the meantime, a holistic approach in treatment decisions remains paramount for older patients. Summary The benefits of primary prevention statin treatment are apparent through age 75, which is reflected in the current ACC/AHA and USPSTF recommendations. Ongoing trials will clarify the utility in those beyond age 75. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.