World-first trial: statins cut heart attacks 30% in healthy over-70s

What just happened

Results from the STAREE trial were published this week in the New England Journal of Medicine — and they answer a question that has been hanging over preventive cardiology for a long time: do statins help healthy older people who have never had a heart attack, stroke, or heart failure?

The answer, it turns out, is yes.

STAREE (Statins in Reducing Events in the Elderly) is a Monash University-led trial that enrolled 9,971 participants across more than 1,000 Australian general practices — with over 3,400 GPs involved. Participants were aged 70 and over, independently living, with no prior cardiovascular disease, diabetes, or dementia. Half took 40mg atorvastatin daily; half took placebo. Average follow-up was six years.

The result: a 30% reduction in major cardiovascular events in the statin group. That includes heart attacks, strokes, and cardiovascular death.

If you have a parent in their 70s whose GP has been having the statin conversation — or if you are approaching that decade yourself — this is the kind of evidence that clarifies the picture. Previously, the evidence for statins in older adults without established heart disease was extrapolated from trials in younger populations or people who already had cardiovascular disease. STAREE is the first trial purpose-built to answer the question in otherwise-healthy older people. And it ran through Australian general practices, with Australian participants.

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The both-and

What the evidence now says — clearly

The STAREE result is, as Professor Mark Nelson put it in the RACGP coverage, “gold-standard evidence.” That is not a phrase clinical researchers throw around loosely. A 9,971-person randomised controlled trial with a six-year follow-up, running through the GP network that actually provides care to older Australians, is as close to definitive as cardiovascular prevention gets.

The New England Journal of Medicine publication is the culmination of a decade-long study. Lead researcher Adjunct Professor Sophia Zoungas described STAREE as a “benchmark for international clinical trials that can directly inform preventive care worldwide.” That is the appropriate scale of this result. Guidelines internationally are expected to update.

The relevance for Australian general practice is direct. GPs now have level I evidence to draw on when counselling patients in their 70s about cardiovascular prevention. Prior to STAREE, conversations about statins in otherwise-healthy older adults happened against a background of extrapolated evidence and clinical uncertainty. That uncertainty is now substantially reduced.

What the trial does not resolve

STAREE is important for what it settles; it is also worth being clear about what it does not.

The trial enrolled people aged 70 and over — it does not tell us what to do at 55 or 65. The 30% figure is a relative risk reduction, which sounds large and is genuinely meaningful, but absolute benefit varies with individual baseline risk. A person at high cardiovascular risk gains more in absolute terms from a statin than a person at very low baseline risk; that calculation is individual and belongs in a GP consultation, not a general recommendation.

Statins also carry side effects for some people. Muscle aches are the most commonly discussed — usually mild, occasionally significant, and dose-dependent. The STAREE trial does not change the individualised risk-benefit conversation that should accompany any statin decision; it changes what the evidence looks like going into that conversation for older adults specifically.

And this trial is not — despite how preventive-cardiology coverage sometimes reads — a directive that everyone aged 70+ should immediately start a statin. It is evidence that for healthy older people without prior cardiovascular disease, the benefit is real and meaningful, and GPs now have solid trial data to draw on.

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My two cents

For most people reading this, STAREE is not directly about you right now. If you are in your 40s, the trial’s participants were three decades ahead of you on the cardiovascular timeline.

But here is the thing the trial actually illuminates about your decade: cardiovascular risk is accumulated. It is not a status you acquire at 70; it is a trajectory that has been running for 20 or 30 years by then. The blood pressure that has been quietly elevated since your mid-40s, the metabolic slow-drift that follows a decade of disrupted sleep and high stress, the smoking that stopped at 48 but started at 20 — these are the inputs to the cardiovascular equation that STAREE’s statin is, in part, compensating for.

The patients in STAREE who did well were already, by definition, the ones who had aged into their 70s in good health. The intervention extended that advantage. The prevention that produced the “healthy over-70s” who enrolled in the trial in the first place happened in the decades before they turned 70.

That is the actual message for women in midlife. Not “ask your GP about statins at 45.” It is: know your blood pressure, know your cholesterol, know your cardiovascular risk score, and address the modifiable factors while they are most modifiable. Whether that conversation leads to a medication, a lifestyle shift, or simply a baseline documented in your record — have it.

Verdict: yes — gold-standard evidence, directly relevant to Australian general practice, worth knowing about.

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Sources cited

1. Statins reduce heart attack risk by 30% in healthy over-70s — newsGP, 31 August 2026. https://www1.racgp.org.au/newsgp/clinical/statins-reduce-heart-attack-risk-by-30-in-healthy
2. STAREE trial — New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMoa2607314