Design: Randomised, double-blind, placebo-controlled trial
Population: 9971 community-dwelling adults aged ≥70 without cardiovascular disease, diabetes or dementia, Australia
Primary outcome: Major cardiovascular events; disability-free survival
Effect: MACE 10.9 vs 15.5 per 1000 person-years, HR 0.70 (95% CI 0.61–0.82); disability-free survival HR 0.94 (0.84–1.05)

STAREE randomised 9971 community-dwelling Australians aged 70 or over, with no cardiovascular disease, diabetes or dementia, to atorvastatin 40 mg or placebo. It had two primary end points: major cardiovascular events, and a composite of death, dementia or persistent physical disability. The trial was published at the end of August 2026.

Over a median 5.9 years, major cardiovascular events fell from 15.5 to 10.9 per 1000 person-years (HR 0.70). Disability-free survival did not differ (HR 0.94). Serious adverse events were similar at 2.7% in each group, although musculoskeletal, hepatobiliary and diabetes-related events were more common on atorvastatin.

This settles one question and leaves another open. Statins prevent heart attacks and strokes in healthy older adults much as they do in younger people. They do not keep people alive and independent for longer over six years. The conversation with an older patient should present both results: fewer vascular events, no extra years free of disability.

Offer primary prevention statins to fit over-70s on the basis of cardiovascular benefit, not longevity
Explain that the trial showed fewer heart attacks and strokes but no gain in disability-free survival
Check glucose during follow-up, since diabetes-related events were more common on atorvastatin
Ask about muscle symptoms at review
Weigh the patient's own priorities, as independence was the outcome that did not change

Why it matters

It answers whether statins benefit healthy over-70s: yes for vascular events, not for staying alive and independent.

The statistics, in plain English

HR 0.70 (95% CI 0.61–0.82) is about a 30% lower rate of major cardiovascular events; the absolute gap is roughly 4.6 events per 1000 people treated each year. For disability-free survival, HR 0.94 (0.84–1.05) crosses 1, so no effect was shown. Because testing was hierarchical, this neutral result is a real finding, not a missed signal.