World-first Australian evidence for the use of statins as primary prevention

A world-first Australian trial has found that cholesterol-lowering medicines can reduce the risk of a first heart attack or stroke in people aged over 70, providing new evidence for the use of statins as a primary prevention treatment in older adults.

Statins are commonly prescribed to manage high cholesterol and are well established as a treatment for reducing the risk of heart attack and stroke. Until now, however, there has been limited evidence about whether the medicines provide the same preventive benefit when treatment is initiated in older people without existing cardiovascular disease.

The findings from the Statins in Reducing Events in the Elderly (STAREE) trial, presented at the European Society of Cardiology Congress 2026, found that the atorvastatin [Lipitor and its generics] reduced the risk of a first major cardiovascular event by 30% among adults aged over 70 who were living independently. However, it “did not result in longer disability-free survival among community-dwelling older adults without clinical cardiovascular disease”.

Lead researcher Adjunct Professor Sophia Zoungas, from the Monash School of Public Health and Preventive Medicine, said “What we hope to see, now that we have provided such strong evidence, are updated treatment guidelines to help clinicians make use of this new finding.”

The results are significant given the burden of cardiovascular disease among older Australians. An estimated 21,000 older Australians suffer major cardiovascular events, including heart attack and stroke, each year. The risk increases with age, meaning people aged over 70 are automatically considered to be in a high-risk category regardless of lifestyle or other factors.

“What an incredible privilege to be part of the STAREE trial that provides definitive evidence for the cardiovascular benefits of statins in healthy people over the age of 70 years. Time for the guidelines to reflect this evidence,” said Professor Stephen Nicholls, Director of the Victorian Heart Institute (VHI) and Professor of Cardiology at Monash University

For Adjunct Professor Zoungas, the findings have implications not only for clinical practice but also for older people and their families.

“The risk of heart attack and stroke is a major concern for older people,” Professor Zoungas said. “Knowing there is a safe and effective measure for lowering that risk will be a huge reassurance to older people and their families. Anyone who has seen a loved one impacted by cardiovascular disease will know just how important prevention is.”

The scale and community-based design of the STAREE trial also give the findings particular relevance to general practice. Professor Mark Nelson, a general practitioner, Adjunct Professor at the Monash School of Public Health and Preventive Medicine and Research Fellow at Menzies Institute for Medical Research at the University of Tasmania, said the study provides critical evidence to support GPs in making decisions about cardiovascular health in older people.

“This was a particularly important trial because it was conducted in the community, with more than 3400 GPs taking part across Australia,” Professor Nelson said. “In light of this new evidence, older patients should have a conversation with their GP about whether statins are an appropriate treatment for their cardiovascular health to help them remain fit and healthy.”

STAREE is one of the largest cardiovascular disease prevention trials ever conducted in older people, positioning Australia at the global forefront of research into healthy ageing.

“With the world’s population ageing at an unprecedented rate, answering fundamental questions about healthy longevity has become a universal imperative,” Professor Zoungas said.“STAREE stands as a benchmark for international clinical trials that can directly inform preventive care worldwide.”

Professor Derek Chew, Chief Scientific and Medical Officer at the National Heart Foundation of Australia, which contributed funding to the trial, welcomed the findings.

“For several decades now, statins have played a major role in reducing cardiovascular events,” Professor Chew said. “This study shows that they can do so even when started much later in life. The Heart Foundation is proud to have supported Professor Sophia Zoungas and her team on this remarkable, long-term study and we congratulate all involved on its important findings.”

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