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Older adults may be able to stop statins — with caveats. The STREAM trial found that stopping statins in adults 70+ without prior cardiovascular disease was noninferior to continuing at 2 years. But by year 4, those who quit had higher rates of heart attacks, strokes, and death — making this a conversation to have with your doctor, not a blanket green light.
Can older adults safely stop statins? It's complicated.
The STREAM trial — a major randomized study of nearly 1,900 adults aged 70 and older — found that stopping statins for primary prevention (i.e., in people who've never had a heart attack or stroke) was noninferior to continuing therapy at the 2-year mark. Presented at the American Heart Association's 2026 Scientific Sessions and simultaneously published in the New England Journal of Medicine, the findings offer some reassurance — but come with a significant asterisk.
By 4 years of follow-up, the picture shifted. Those who discontinued statins had meaningfully higher rates of MI, ischemic stroke, and all-cause death compared to those who stayed on therapy. Notably, stopping statins didn't improve quality of life, muscle pain, falls, or sarcopenia — undermining a key argument for quitting in the first place.
By the Numbers:
Why it matters: This trial gives clinicians and patients real data to guide shared decision-making about statin deprescribing in older adults — a common and often nuanced clinical conversation. The bottom line: if an older patient is tolerating their statin well, the evidence now suggests staying the course is the safer bet.
