Should you take a statin after 70? Atorvastatin cut heart events 30% in a 9,971-person trial

A 9,971-person trial found atorvastatin cut heart events 30% in healthy adults over 70, with no gain in disability-free life and more muscle and liver problems.

Published November 2026

Short answer

Atorvastatin cut major heart events by 30% in healthy adults over 70, but did not lengthen disability-free life, and muscle, liver and diabetes-related problems were more common. Evidence grade B (Moderate). One large double-blind trial of 9,971 people plus consistent meta-analyses of statin trials; downgraded once because only one trial tested healthy people over 70 and the second main outcome showed no benefit.

Key takeaways

In 9,971 healthy adults aged 70 and older, atorvastatin 40 mg a day cut major heart events by 30% over a median of 5.9 years: 297 people on the statin had one against 412 on a dummy pill [1].
It did not help people stay alive without dementia or lasting disability for longer: 637 people on the statin and 676 on the dummy pill reached one of those outcomes [1].
Muscle and joint, liver and bile-duct, and diabetes-related problems were more common on atorvastatin, although serious side effects overall were equal at 2.7% in each group [1].
Older meta-analyses of statin trials also found fewer heart and stroke events across age groups, with thinner evidence for people over 75 without heart disease [2][3].
The trial tested healthy people, one statin and one dose, so it cannot say who should start one; that is a decision to make with a doctor [1].

The studies in numbers

Charts drawn from the numbers the cited studies report. They are not a new analysis.

Atorvastatin in healthy adults over 70: the two main questions
STAREE trial, 9,971 people, median 5.9 years

Randomised, double-blind trial. A value below 1 means lower risk on atorvastatin. The heart-events row is clearly below 1. The disability-free survival row crosses 1, so no benefit was shown.

Numbers from: Abstract, Results. Sources: Major heart events, Death, dementia or lasting disability.

See the numbers

Study	Ratio (95% CI)
Major heart events	0.7 (0.61–0.82)
Death, dementia or lasting disability	0.94 (0.84–1.05)

What the study did

Should you take a statin after 70? The STAREE trial tested this in people with no heart disease, diabetes or dementia. At general medical practices across Australia, 9,971 adults aged 70 or older were randomly given either atorvastatin (a statin) at 40 mg once a day or an identical dummy pill. The trial was double-blind, so neither the participants nor the researchers knew who got which [1]. The average age was 74.7 and 51.9% were women. People were followed for a median of 5.9 years [1].

The trial had two main questions. The first was whether atorvastatin lowers major heart events: death from heart causes, a nonfatal heart attack or stroke, or a procedure to reopen heart arteries. The second was whether it helps people stay alive without dementia or lasting physical disability, which the authors call disability-free survival [1]. The trial was funded by the National Health and Medical Research Council and others [1].

What it found

Fewer heart events. A major heart event happened to 297 people on atorvastatin (10.9 per 1,000 people per year) and 412 people on the dummy pill (15.5 per 1,000 people per year). That is a 30% lower risk with the statin [1]. In both groups, most people had no such event during the trial [1].

No gain in disability-free survival. Death from any cause, dementia or lasting physical disability happened to 637 people on atorvastatin (21.6 per 1,000 people per year) and 676 on the dummy pill (23.0 per 1,000 people per year). That small gap could easily be chance, so atorvastatin did not help people stay alive and free of dementia and disability for longer [1].

More muscle, liver and diabetes-related problems. Serious side effects overall were equally common, at 2.7% in each group (131 people on atorvastatin and 129 on the dummy pill). But muscle and joint problems, liver and bile-duct problems, and diabetes-related problems were all more common on atorvastatin [1]. The abstract does not say how many more.

How it fits

The heart benefit matches the older evidence. A review of 22 trials with 90,624 adults who had not had a heart event found statins linked to fewer deaths from any cause and fewer strokes and heart attacks. About 1.3 fewer people in 100 had a heart or blood-vessel event. Data for people older than 75 were sparse [3]. A pooled analysis of 28 trials found statins cut major vascular events in every age group, though there was less direct evidence for people over 75 without existing heart disease [2]. STAREE helps fill that gap.

The side-effect picture is less clear-cut. Pooled analyses of earlier trials found statins linked to a small rise in muscle symptoms and liver problems. In a 62-trial review, that was about 15 extra muscle-symptom cases and 8 extra liver-dysfunction cases per 10,000 people treated for a year [4]. An analysis of 19 large placebo-controlled trials (average age 63) found most muscle complaints on a statin were not caused by the drug, and any excess appeared in the first year [5]. The 2022 USPSTF review (the US panel that advises on preventive care) found no significant rise in diabetes overall, but one trial of high-intensity statins did find more [3].

An earlier look at healthy people over 70 who happened to take statins, rather than being randomly assigned, found the same split as STAREE. Statin use was linked to fewer cardiovascular problems and less physical disability, but not to longer disability-free survival. That kind of study cannot show cause and effect [6].

For the full picture of what statins can and cannot do, see the Statins page.

Limits

STAREE enrolled generally healthy people aged 70 and older without heart disease, diabetes or dementia, so it cannot speak to people with those conditions [1].
It tested one drug and dose, atorvastatin 40 mg a day, over a median of 5.9 years [1].
The abstract does not give the number of muscle, liver and diabetes-related problems, so we cannot say how big the extra risk was [1].
A 30% lower risk is a relative figure. It describes the group, not how much a particular person gains. The trial cannot tell who should start a statin, which is a decision to make with a doctor [1].

Go deeper

Statins — In adults without heart disease, statins cut heart attacks and strokes; in the 2026 STAREE trial, atorvastatin cut major heart events by 30% in people over 70.