French Randomized Trial Finds Statin Stopping At Age 75 Did Not Raise Three-Year Deaths In Low-Risk Adults

A randomized trial in France found that adults over 75 who had been taking statins for primary prevention did not have higher three-year death rates after stopping the drugs, compared with peers who stayed on treatment. The study, published Tuesday in the Lancet Healthy Longevity, focused on people with no history of cardiovascular disease and adds controlled trial evidence to a debate that has mostly relied on observational data.

The result is narrower than a general case for deprescribing. The authors do not advise doctors to broadly stop statins in older adults, and the trial does not show that going off therapy is better than continuing it. Instead, it supports a more individualized discussion for a relatively healthy group whose risk profile, life expectancy, and care setting may differ from many older patients, especially outside France.

The data

Researchers enrolled 1,160 patients through general practitioners’ offices across France. Participants had an average age of 80, had been prescribed statins for at least one year to prevent atherosclerotic cardiovascular disease, and most had been on the drugs for at least five years. They were randomly assigned either to continue statins or discontinue them and then followed for three years.

The clearest biological effect appeared early. After three months, LDL cholesterol in the discontinuation group rose 50%, increasing from 115 to 171 mg/dL, while LDL levels in the continuation group did not change. Even with that divergence in cholesterol, the trial did not find a significant difference in major cardiovascular events such as heart attacks and strokes between the two groups over the full follow-up period.

Mortality was also similar. After three years, 7.2% of people in the discontinuation group had died, equal to 35 of 484 patients, compared with 7.9% in the continuation group, or 48 of 604. STAT reported those death rates were about half the national average of 15% in France, which reinforces how selected and relatively healthy this study population was.

Quality-of-life measures did not improve with discontinuation. Physical and mental assessments remained the same in both groups over the three years. Study co-author Fabrice Bonnet told STAT the researchers had been a little disappointed not to see a quality-of-life benefit from stopping statins. One explanation he offered was selection: patients troubled by side effects may already have stopped treatment before enrollment, leaving a trial population less likely to gain symptom relief from discontinuation.

Why the result is narrower than it looks

The most important limitation is population specificity. France has universal health care, lower cardiovascular mortality than the U.S. among high-income countries, and higher longevity than the U.S. Bonnet said the findings need confirmation in other populations, over a longer period, and in people at higher cardiovascular risk or who are otherwise less healthy than the participants in this trial.

Romit Bhattacharya of the Mass General Brigham Heart and Vascular Institute, who was not involved in the research, told STAT that for the majority of American patients over the age of 75, the trial will not change anything. His read was that the study offers more flexibility for healthy older individuals with a shorter time horizon, rather than a new default standard.

That distinction matters because the trial cuts against larger cohort studies from 2021 in Denmark and Italy, which found about a 30% higher risk for fatal and nonfatal cardiovascular outcomes after statin discontinuation in older adults. The Lancet authors argued those earlier studies could not fully account for why patients stopped therapy in the first place. In nonrandomized settings, discontinuation can reflect worsening health, complications, or other conditions, creating bias that a randomized design is meant to reduce.

The industry signal

For statin makers, the study does not challenge the class’s long-established benefit in reducing heart attack and stroke risk by 25% since introduction in 1987. It does, however, add evidence to the broader push to reassess medication burden in older adults as polypharmacy grows across blood pressure, heart failure, obesity, diabetes, and cholesterol treatment.

That means the commercial pressure is likely to be selective, not structural. The immediate implication is less about broad demand erosion and more about giving clinicians and patients support for case-by-case deprescribing conversations in low-risk elders. The study also leaves intact the basic side-effect profile described in the source: muscle pain in about 1% of people and a small rise in blood sugar that could push some patients on the cusp into type 2 diabetes.

For now, the strongest takeaway is that elevated LDL after stopping statins in healthy adults over 75 did not translate into worse three-year clinical outcomes in this specific French population. Whether that remains true over longer follow-up or in sicker and higher-risk groups is the unresolved question the trial itself leaves behind.