Plate Nº 28 · recorded November 12, 2026
Health & Medicine ResearchReported finding
Statins after 70: STREAM trial finds stopping carries measurable risk
The STREAM trial of 1,880 adults over 70 found stopping statins stayed within a preset safety limit, yet heart attacks, strokes and deaths rose from 9.2% to 12.7%.
By Marcus Bennett3 min read605 words
In brief
- 12.7% of participants who stopped statins had a heart attack, ischemic stroke or died, versus 9.2% who continued.
- The STREAM trial followed 1,880 adults aged 70+ (average age 77) at 24 centers in Switzerland, France and the Netherlands.
- The average difference in healthy time was about two weeks in favor of continuing, within the preset 5.2-week safety threshold.
- Quality of life, muscle pain, falls and muscle loss showed no clear advantage from stopping.
- About 14% of participants crossed over between groups during the roughly 103-week follow-up.
Older adults who stopped taking statins suffered a heart attack, ischemic stroke or death in 12.7% of cases over roughly two years, compared with 9.2% of those who kept taking the drug. That is the central result of the STREAM trial, published in The New England Journal of Medicine, and it defines the trade-off now facing clinicians who treat patients in their seventies and beyond.
The trial did not deliver a verdict of "keep everyone on statins" — but it did not greenlight a blanket stop either. Its main analysis met a preset safety threshold, meaning stopping did not cause what the researchers had defined in advance as an unacceptable loss of healthy time. Yet the raw event numbers ran clearly against the stopping group.
What did the trial measure?
Researchers recruited 1,880 adults aged at least 70 across 24 centers in Switzerland, France and the Netherlands. Every participant had two or more chronic conditions, took a statin purely for prevention, and had no known cardiovascular disease. Average age was about 77.
The team randomly assigned 938 people to stop cholesterol-lowering treatment and 942 to continue. The primary question: would stopping cause an unacceptable loss of time alive without a heart attack or ischemic stroke — a stroke caused by a blocked blood vessel — over two years?
The researchers fixed that "unacceptable" bar before the trial started: more than 5.2 weeks of healthy time lost on average. The measured difference came in at about two weeks in favor of continuing treatment, inside the chosen limit.
That statistical verdict is the nuance practitioners need to hold onto. Meeting a non-inferiority threshold does not mean the two strategies produced identical outcomes, and it does not mean stopping carried no added risk. The event figures — 12.7% versus 9.2% over a typical follow-up of about 103 weeks — show the additional risk plainly.
Did stopping improve quality of life?
No. The study also tracked quality of life, muscle pain, falls and muscle loss — the side-effect concerns that often drive older patients to want off statins in the first place. None of these measures showed a clear advantage from stopping.
Serious medical events of any kind occurred in 43.0% of the stopping group and 39.8% of the continuation group. For patients weighing a daily pill burden against benefit, the trial offered no measurable payoff on the other side of the ledger.
What limits the findings?
About 14% of participants crossed over — restarting statins or stopping despite their assignment. The researchers ran additional analyses to account for this, but the crossover muddies any claim about what would happen if every patient followed one strategy exactly.
The results also apply only to the population studied: older adults taking statins for prevention. People with a previous heart attack, stroke or established cardiovascular disease were excluded, so the numbers say nothing about secondary prevention.
What changes at the prescription pad?
For clinicians, STREAM converts a vague question — "should my older patient keep taking this?" — into a concrete conversation. The decision now weighs a possible increase in cardiovascular events against a person's other conditions, treatment burden and personal preferences. Any change should go through the prescribing clinician, not around them.
For patients juggling multiple medicines, reducing treatment can genuinely lessen a daily burden. The trial simply shows that in this group, the price of stopping was measurable, and the hoped-for gains in comfort and function did not materialize.
The evidence supports individualized decisions in later life — not a blanket rule in either direction.
Source: University of Bern and University of California, San Francisco.
via knowridge.com (Source)
More from Marcus Bennett
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News editor covering regulation, policy and their impact on general science news at SciBeat.
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