Melbourne, A major Australian clinical trial has produced new evidence that could influence how doctors approach cholesterol-lowering treatment in older adults.

Researchers from the STAREE (Statins in Reducing Events in the Elderly) trial found that daily atorvastatin significantly reduced the occurrence of major cardiovascular events among independently living people aged 70 and above who had no previous cardiovascular disease, diabetes or dementia.

The results were presented at the European Society of Cardiology Congress 2026 and published simultaneously in the New England Journal of Medicine.

A Long-Standing Medical Question

Statins are among the most widely used medicines for lowering cholesterol and preventing cardiovascular disease.

Doctors have strong evidence supporting their use in many younger adults and people who have already experienced cardiovascular problems.

However, the picture has been less certain for otherwise healthy older adults, particularly those beyond 75.

Older people have historically been underrepresented in major statin trials, leaving physicians with less direct evidence when deciding whether to begin preventive treatment in this population.

The STAREE trial was designed specifically to address that evidence gap.

Nearly 10,000 Older Australians Took Part

The study enrolled 9,971 participants aged 70 or older through Australian general practices.

Participants had no previous clinical cardiovascular disease, diabetes or dementia when they entered the study.

The average age was approximately 74.7 years, and women represented about 52% of the participants. Around 40% were at least 75 years old.

Participants were randomly assigned to receive either 40 milligrams of atorvastatin each day or an identical placebo.

The double-blind design meant that neither participants nor investigators knew which treatment individuals had been assigned during the trial.

Cardiovascular Events Fell by 30%

After a median follow-up of 5.9 years, the researchers found a substantial difference in major cardiovascular events.

Such events included cardiovascular death, nonfatal heart attack, stroke or coronary revascularisation.

These events occurred in 6.0% of participants receiving atorvastatin, compared with 8.3% in the placebo group.

That corresponded to a 30% relative reduction in the combined cardiovascular outcome.

The result was statistically significant and provides unusually strong randomised evidence for the use of statins as primary prevention in selected older adults.

The Result Does Not Mean Statins Are Right for Everyone

Despite the encouraging findings, the study does not mean every person over 70 should automatically begin taking a statin.

The participants were carefully selected and did not have cardiovascular disease, diabetes or dementia.

Doctors also need to consider an individual’s overall cardiovascular risk, other medicines, medical conditions, potential side effects and personal preferences.

The researchers say the findings should help inform clinical discussions rather than replace individual medical assessment.

No Significant Improvement in Disability-Free Survival

The trial produced a different result for its second major outcome.

Researchers wanted to know whether statin treatment could help older adults remain alive without developing dementia or persistent physical disability.

The study did not find a statistically significant improvement in this measure.

Death, dementia or persistent physical disability occurred in 12.8% of the atorvastatin group compared with 13.6% of the placebo group.

This distinction is important.

The research demonstrated fewer major cardiovascular events, but it did not demonstrate that the medicine extended disability-free life.

Serious Side Effects Were Uncommon

Safety was another major consideration because older adults often take multiple medicines and may be more vulnerable to adverse effects.

The trial found that muscle-, liver- and diabetes-related adverse events were more frequent among participants receiving atorvastatin.

However, serious adverse events occurred in 2.7% of participants in both groups, according to the reported results.

The findings therefore provide reassurance about serious complications while still showing that potential side effects need to be considered.

The Dementia Question

Concerns about whether statins could increase dementia risk have contributed to uncertainty surrounding their use among older people.

The STAREE findings did not show a statistically significant increase in dementia between the treatment and placebo groups.

That finding could be particularly relevant for older patients who have been hesitant to consider cholesterol-lowering treatment because of fears surrounding cognitive health.

However, the study was designed around several outcomes, and the results should be interpreted within the full clinical context rather than as proof that statins prevent dementia.

Why the Research Could Influence Guidelines

The significance of STAREE lies partly in the population it studied.

Previous evidence left uncertainty about starting statins in otherwise healthy people at advanced ages.

This trial provides direct randomised evidence showing a reduction in major cardiovascular events among the selected population.

Researchers hope the results will contribute to future updates of treatment guidelines.

Such changes would ultimately depend on independent assessment of the full evidence and consideration of other clinical trials.

A Growing Health Challenge

The research arrives as populations around the world become older.

Cardiovascular disease remains one of the leading causes of illness and death, while older adults account for an increasing proportion of many countries’ populations.

Finding effective ways to prevent heart attacks and strokes without unnecessarily increasing treatment-related risks is therefore becoming increasingly important.

The STAREE results provide new information for that debate.

The Importance of Absolute Risk

Although a 30% relative reduction sounds substantial, doctors also need to consider the absolute difference between the two groups.

Major cardiovascular events occurred in 6.0% of people receiving atorvastatin compared with 8.3% receiving placebo over the study period.

That represents an absolute difference of 2.3 percentage points.

In practical terms, the potential benefit will vary according to an individual’s starting level of cardiovascular risk.

A Decade-Long Research Effort

STAREE was not a short-term experiment.

The research programme involved years of recruitment, treatment and follow-up across Australia’s general-practice network.

More than 3,400 general practitioners contributed to the study, helping researchers recruit and follow participants in community settings.

That broad participation allowed the trial to examine statin treatment among people living independently rather than focusing exclusively on hospital patients.

What the Findings Mean for Patients

The new evidence gives doctors a stronger basis for discussing preventive statin therapy with older adults.

For someone over 70 who has never experienced a heart attack or stroke, the decision can now be informed by a large randomised trial specifically involving people in that age group.

But the correct choice remains individual.

Patients should not start, stop or change prescription medicines solely because of a news report.

Instead, the study’s findings can form part of a conversation with a qualified healthcare professional about cardiovascular risk and treatment options.

More Research Is Still Needed

The STAREE findings answer an important question, but they do not resolve every uncertainty.

Researchers still need to understand how the results apply to populations with different ethnic backgrounds, health profiles and levels of cardiovascular risk.

Further studies may also help determine which older adults are most likely to receive a meaningful benefit from preventive statin therapy.

Another important area will be understanding how the findings interact with other preventive strategies, including exercise, blood-pressure control, smoking cessation and dietary changes.

A New Chapter in Preventive Cardiology

The STAREE trial represents a significant development in research on cardiovascular prevention in older adults.

Its central finding is clear: among the selected adults aged 70 and above who participated in the trial, daily atorvastatin reduced major cardiovascular events by about 30% relative to placebo.

At the same time, the study did not show a significant improvement in disability-free survival.

That combination of findings provides a more nuanced picture than simply saying that statins “work” or “do not work” in older people.

The research shows a meaningful reduction in serious cardiovascular events while leaving important questions about healthy longevity unanswered.

As the global population continues to age, evidence such as STAREE could become increasingly important in helping doctors and patients make informed decisions about long-term cardiovascular prevention.