Stopping statins after 70? New trial says it's possible — but not without risk

The STREAM trial, presented at the American Heart Association 2026 Scientific Sessions and published in the New England Journal of Medicine, tackled a question many older patients ask their doctors: "Can I stop my statin?" For adults 70 and older with multiple chronic conditions but no known cardiovascular disease, the answer is nuanced — stopping was noninferior to continuing at the 2-year mark, but the gap widened meaningfully by year four.

Crucially, stopping statins didn't make patients feel better. There were no improvements in quality of life, pain, falls, or sarcopenia risk — undermining a key argument for quitting. Experts caution that the findings should not be read as a green light to deprescribe broadly, but rather as evidence to support individualized, shared decision-making.

By the Numbers:

• 1,880 patients enrolled (mean age 77.5; ~47% women)
• Event-free survival at 2 years: 96.5 weeks (discontinuation) vs. 98.5 weeks (continuation)
• At 4 years: MI rates 1.6% vs. 0.6%; stroke 2.2% vs. 0.8%; all-cause death 9.8% vs. 8.0%
• 1 additional CV event for every 40 patients who stopped statins over 2 years

Why it matters: As polypharmacy grows among older adults, deprescribing is increasingly on the table — but STREAM shows that stopping statins isn't risk-free, even in primary prevention. Clinicians need robust, patient-centered conversations before making any changes.