Grant: Operating Grant - PA: Institute of Health Services and Policy Research

Statins reduce cardiovascular disease (CVD) adverse outcomes in the general population and large well-designed prospective randomized studies (RCTs) have demonstrated cardiovascular benefits of use of statins in the general population. However, statins may have adverse effects - especially in the elderly population who are more vulnerable to drug induced side effects. We will use a large population-based cohort of 1.9 million subjects receiving care in a universal health care system to compare the rates of change in estimated glomerular filtration rate (eGFR) and proteinuria among elderly statin-users, as compared with non-users or users of other lipid-modifying medications such as fibrates or ezetimibe. We will also ascertain the risk of certain major adverse events (rhabdomyolysis, incident acute kidney injury, major cardiovascular events) associated with statin use in the population, as compared with non-users or users of other lipid-modifying medications. A major focus of the work will be to compare different statins with each other, as well as to search for a dose effect of statins on the outcomes of interest. These analyses will help to improve the rational prescription of statins to elderly patients in the general population.