The major randomized controlled trials (RCTs) that established the benefits of statins in preventing atherosclerotic cardiovascular disease (ASCVD) generally did not enroll persons older than 75 years. Once a patient who has been taking a statin for primary prevention reaches that age, are there additional benefits to continuing it, or conversely, are there harms associated with discontinuing? In 2020, a systematic review of international guidelines on cardiovascular disease prevention found “little specific guidance for physicians who are considering statin discontinuation in older adults in the context of declining health status and short life expectancy.” A 2024 systematic review identified 35 observational studies and a single RCT comparing statin discontinuation to continuation. The observational studies showed that statin discontinuation in all age groups was associated with statistically significant increases in all-cause mortality (hazard ratio (HR) = 1.92), cardiovascula...