Older adults who stopped taking statins experienced more heart attacks, ischemic strokes or deaths than those who continued treatment in a new randomized trial, raising caution about routinely withdrawing the cholesterol-lowering drugs.
The international STREAM trial nevertheless met its prespecified statistical criterion for noninferiority at two years. That finding does not mean stopping treatment was risk-free or that the two approaches produced identical outcomes.
The results were presented on November 7 at the American Heart Association Scientific Sessions 2026 and simultaneously published in The New England Journal of Medicine, according to the American College of Cardiology’s account of the trial.
What the statin trial found
The study involved approximately 1,880 adults aged 70 and older who were already taking statins to prevent a first cardiovascular event. Participants had at least two chronic conditions but no known cardiovascular disease. Researchers randomly assigned them to stop or continue statin treatment.
Over a median follow-up of 103 weeks, 119 participants in the discontinuation group, or 12.7%, experienced the combined primary outcome of a major cardiovascular event or death from any cause. That compared with 87 participants, or 9.2%, in the continuation group, the ACC reported.
The difference was 3.5 percentage points. These figures describe a combined outcome: they should not be read as death rates alone or as separate estimates for heart attacks and strokes.
At least one serious adverse event occurred in 43% of participants assigned to stop statins, compared with 39.8% assigned to continue. Those totals do not establish that every event was caused by stopping treatment.
Why the statistical result needs context
The researchers assessed noninferiority using the difference between the groups in restricted mean event-free survival time over two years. In practical terms, that measure compares the average time participants remained free of the trial’s combined outcome during a fixed period.
The between-group difference was minus two weeks, according to the ACC. Although the trial met its predefined noninferiority criterion, the higher number of events in the discontinuation group remains important when interpreting the findings.
Presenting researcher Nicolas Rodondi emphasized shared decision-making in light of the increase in cardiovascular events after discontinuation. The trial’s data and safety monitoring board also recommended advising participants assigned to stop treatment to discuss restarting statins with their care teams, the ACC said.
No clear improvement in muscle pain or quality of life
The New York Post’s report on the study said researchers found no meaningful differences between groups in reported quality of life, muscle pain, falls or loss of muscle mass and strength.
The report also noted that about 14% of participants did not remain with their assigned treatment strategy: some restarted statins after being assigned to stop, while others stopped despite being assigned to continue. Such crossover complicates interpretation of a comparison between treatment strategies.
The findings do not apply to every older patient
STREAM addressed a specific question: whether older people with multiple chronic conditions and no established cardiovascular disease could discontinue statins prescribed for primary prevention. It did not test withdrawing treatment in patients with a previous heart attack or stroke.
The typical follow-up was about two years, although some participants were followed for longer. The findings therefore do not settle what happens when treatment is stopped for many years.
Statins lower LDL cholesterol and are used to reduce cardiovascular risk. The new trial examined discontinuation; it should not be interpreted as evidence that continuing statins is newly dangerous.
For patients considering a change, the study supports an individualized discussion with the prescribing clinician rather than a blanket decision based on age. Patients should not stop a prescribed statin on the basis of a news report without discussing their circumstances with their healthcare team.
