Statins After 70: What the STAREE Trial Actually Found

For older adults who have never had a heart attack or stroke, should taking a statin be part of the plan for a longer, healthier life?

It’s a reasonable question. Many people in their 70s already take several medications, and adding another long-term prescription should offer a benefit that matters to them.

The Australian STAREE trial set out to investigate that question in nearly 10,000 adults aged 70 and older. Researchers tested whether a statin could prevent major cardiovascular events—and whether it could also extend the years people live without dementia or persistent physical disability.

The results, published in the New England Journal of Medicine in August 2026, offer a clear answer to the first question and a more complicated one to the second.

What did the researchers study?

STAREE enrolled 9,971 community-dwelling adults through general medical practices across Australia. Participants had a mean age of 74.7, and 51.9% were women. They had no history of clinical cardiovascular disease, diabetes or dementia.

Participants were randomly assigned to take either 40 mg of atorvastatin daily or a placebo. Neither participants nor researchers knew who received which treatment. The median follow-up was 5.9 years.

This was a trial of primary prevention: preventing a first recognized cardiovascular event, rather than preventing another event in someone who had already experienced one.

That distinction matters. The findings do not directly answer questions about people with established cardiovascular disease, diabetes or dementia. And having no previous heart attack or stroke does not necessarily mean having no underlying atherosclerosis.

Finding 1: Fewer major cardiovascular events

The clearest result was a reduction in major cardiovascular events among participants assigned to atorvastatin.

Over a median of 5.9 years:

• Atorvastatin: 6.0% experienced a major cardiovascular event.
• Placebo: 8.3% experienced a major cardiovascular event.

That is an absolute difference of about 2.3 percentage points and a relative risk reduction of approximately 30%.

In practical terms, roughly 6 out of every 100 people in the atorvastatin group experienced the measured outcome, compared with about 8 out of every 100 in the placebo group.

The trial’s cardiovascular outcome combined cardiovascular death, nonfatal heart attack or stroke, and coronary revascularization—a procedure to restore blood flow to the heart.

The 30% reduction applies to this combined outcome, not to heart attacks and strokes alone.

The absolute difference is also important. A 30% relative reduction can sound dramatic, but the benefit an individual can expect depends on their underlying cardiovascular risk. In this trial, the difference between groups was about two to three people per 100 over the follow-up period.

For some people, preventing a heart attack or stroke could mean preserving mobility, independence and quality of life. That is a meaningful benefit in its own right.

Finding 2: No demonstrated extension of disability-free survival

The second primary outcome asked a broader question: did atorvastatin help people live longer without death, dementia or persistent physical disability?

The answer was less encouraging.

The combined outcome occurred in:

• Atorvastatin: 637 participants.
• Placebo: 676 participants.

The difference was not statistically significant. The estimated hazard ratio was 0.94, with a 95% confidence interval of 0.84 to 1.05.

In plain English, the trial did not establish that atorvastatin improved disability-free survival.

That does not prove the drug has no effect on healthy aging. The results remain compatible with some benefit or some harm. But the trial did not provide convincing evidence that taking atorvastatin extended the period people lived without the combined outcome.

This distinction is central to understanding STAREE. Preventing cardiovascular events can help preserve independence, but a reduction in cardiovascular events does not automatically establish that a treatment extends disability-free life.

The two findings are not contradictory. They measure different things.

Did the statin help people live longer?

STAREE did not establish an overall survival advantage. Death from any cause was included in the broader composite outcome, but that composite did not differ significantly between groups.

Nor did the trial establish that atorvastatin prevented dementia.

These are important limits. It would be inaccurate to claim that STAREE proved statins extend life or protect against dementia in otherwise relatively healthy adults over 70.

It would be equally inaccurate to conclude that the drug offered no meaningful benefit. The reduction in major cardiovascular events was statistically significant and clinically relevant.

What about side effects?

Serious adverse events occurred in 2.7% of participants in each group.

However, musculoskeletal, hepatobiliary and diabetes-related adverse events were reported more often in the atorvastatin group.

The overall similarity in serious adverse events is reassuring, but it does not mean the medication was free of side effects. Nor does it mean every older adult will experience the same balance of benefit and harm.

A person who develops troublesome muscle symptoms, for example, may weigh the decision differently from someone who tolerates treatment easily. Other medications, existing conditions, individual cardiovascular risk and personal priorities also matter.

The right question is not simply whether a drug works on average. It is whether its likely benefit outweighs its burden for the person considering it.

Who do these findings apply to?

STAREE provides unusually useful randomized evidence for people aged 70 and older who have no history of clinical cardiovascular disease, diabetes or dementia.

But the participants were community-dwelling Australians recruited through general practices. The results may not translate directly to every older adult, particularly people who are frail, have multiple serious illnesses or fall outside the trial’s eligibility criteria.

The study also should not be used as a reason for someone already taking a statin to stop treatment. STAREE compared assignment to atorvastatin with assignment to placebo; it was not a trial designed to determine whether established statin users should discontinue their medication.

And age alone does not determine cardiovascular risk. Two people aged 75 may have very different cholesterol levels, blood pressure, smoking histories, family histories and burdens of atherosclerosis.

What should someone over 70 take from STAREE?

The trial sharpens the discussion rather than settling every individual decision.

For an older adult without a previous cardiovascular event, useful questions include:

• What is my estimated risk of a heart attack or stroke, and how much could treatment reduce it in absolute terms?
• What evidence supports treatment in someone with my medical history?
• What side effects or medication interactions are relevant to me?
• How do I weigh a lower cardiovascular risk against the daily burden of another medication?
• If I am already taking a statin, what is the reason for continuing it, and has that reason changed?

These questions are best discussed with a healthcare professional who knows the person’s history. STAREE is evidence for a conversation, not a universal instruction to start or stop medication.

The Watchdog Takeaway