# Statins for Primary Prevention of Cardiovascular Disease and Frailty

> **NIH VA IK2** · VA BOSTON HEALTH CARE SYSTEM · 2021 · —

## Abstract

Statins are highly effective cholesterol-lowering medications used for primary prevention of
cardiovascular disease (CVD) and are one of the most commonly prescribed medications.
However, data on safety and efficacy of statins for primary prevention of CVD in adults over 75
years is scarce and as a result, the 2013 American College of Cardiology/American Heart
Association cholesterol guidelines do not support routine use of statins for primary prevention
after age 75. Current VA guidelines do not address the issue of age and recommend that all
Veterans at moderate risk of CVD should be prescribed at least a moderate intensity statin,
including the 4.5 million veterans who are over 75 years. Furthermore, the risk of CVD rises with
age and is closely linked to frailty, a multidimensional state of vulnerability that is associated
with an increased risk of disease, disability, death, and healthcare costs. Those who are frail are
at increased risk of incident CVD while those with CVD are at increased risk of de novo frailty.
CVD and frailty share common biologic pathways and risk factors, such as inflammation, raising
the possibility that statins may prevent or slow time to frailty. However, whether statins can
prevent frailty is unknown. As Veterans age, identifying preventive strategies for common
conditions such as CVD and frailty is critical. Therefore, the research activities in this career
development award will use a retrospective design to test the hypotheses that (1) statins, taken
for primary prevention, are associated with a lower risk of major cardiovascular events (fatal and
non-fatal myocardial infarction, acute coronary syndrome, coronary revascularization, and
stroke) and mortality in veterans ≥75 years and (2) statin use is associated with a lower risk of
frailty over a minimum 10 years of follow up in Veterans ≥65. We will also examine the role of
statin intensity for both the primary prevention of CVD and frailty. Our secondary aims will test
the hypotheses that statin use is associated with (i) a non-significant risk of cognitive decline,
and myalgias and (ii) a faster gait speed – a surrogate of frailty – among older veterans. This
work will inform the design of future clinical trials of statins for prevention of CVD in adults over
75 years and prevention of frailty. In addition to the pharmacoepidemiologic study proposed, this
career development award includes mentorship, coursework, and seminars in advanced
epidemiologic and statistical methods, geriatrics, and cardiology. The research and career
development activities will prepare the applicant for her long-term goal of a research career in
geriatric preventive cardiology and will inform Veteran preventive care, health, and aging.

## Key facts

- **NIH application ID:** 9816565
- **Project number:** 5IK2CX001800-02
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Ariela R Orkaby
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9816565

## Citation

> US National Institutes of Health, RePORTER application 9816565, Statins for Primary Prevention of Cardiovascular Disease and Frailty (5IK2CX001800-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9816565. Licensed CC0.

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