Statin Use for Primary Prevention in the Elderly Without Established Cardiovascular Disease: A Literature Review

Introduction: Statins, discovered in the 1970s by Akira Endo, revolutionized the treatment of cardiovascular diseases by inhibiting the enzyme HMG-CoA reductase, reducing LDL cholesterol levels.Its use has been consolidated in both primary and secondary prevention of cardiovascular events, and its pleiotropic effects, such as anti-inflammatory action and stabilization of atherosclerotic plaques, extend its clinical benefit.Despite its efficacy, its use in the elderly is still surrounded by doubts, especially regarding safety, adverse effects and real benefit in patients with greater frailty or multiple comorbidities.Method: A narrative literature review was carried out using the Virtual Health Library (VHL) and PUBMED databases.The descriptors "statin", "elderly", "primary prevention" and "cardiovascular disease" were used without initial restrictions.After applying inclusion criteria (full articles, free of charge, published in the last five years, in English or Portuguese) and exclusion criteria (undated articles, editorials, letters, PowerPoint presentations and unclear methodology), six articles were selected for analysis and synthesis.Results and Discussion: Analysis of the studies revealed that although the elderly are at increased risk of cardiovascular events, they often receive less treatment due to fear of adverse effects and doubts about the efficacy of statins in this age group.Recent literature shows that, with adequate monitoring , statins are also safe and effective in the elderly, with benefits observed in reducing heart attacks and mortality, even in people over 75.However, adverse effects such as muscle symptoms and liver changes, although generally mild, reinforce the need for individual assessment.Guidelines are still inconsistent for older people over 75, especially the very frail, making a personalized approach essential.Conclusion: The review shows that the use of statins for primary prevention in the elderly can bring benefits, but their indication should be cautious and individualized.More robust evidence is still needed to confirm their efficacy and safety in this group.Therefore, the use of statins is only recommended in patients with moderate to long life expectancy, taking into account comorbidities, frailty and patient preferences, always with careful medical monitoring.