法国学者在无已知血管事件的老年人中研究了降脂药物(他汀或贝特类)与冠心病和卒中长期风险的关系，结果表明，他汀或贝特类药物可减少上述人群30%的卒中发生率。相关论文5月19日在线发表于《英国医学杂志》(简称BMJ)杂志。

        研究者们随机纳入了居住在法国3个城市社区人群7484例，年龄≥65岁(平均年龄73.9岁)，女性占63%，入组时受试者均无无已知血管事件病史。平均随访9.1年。利用多变量Cox比例风险模型校正许多潜在混淆因素后，计算基线时用降脂药和未用降脂药受试者的冠心病和卒中校正危险比(HR)。分别评估使用任意降脂药(他汀和贝特类)的危险比。

        结果显示，与未使用降脂药受试者相比。使用降脂药的受试者卒中风险减少(HR0.66，95%置信区间0.49~0.90);他汀和贝特类药物使用者的卒中HR相似，分别为(0.68，0.45~1.01)和(0.66，0.44 ~ 0.98)。降脂药的使用和冠心病无关(HR 1.12，0.90~1.40)。

        基于年龄、性别、体质指数、高血压、收缩压、甘油三酯浓度和倾向评分的分层分析显示，这些变量对卒中或冠心病无任何修正作用。

        参考文献：AnnickAlpérovitch,et al.BMJ2015;350doi: http://dx.doi.org/10.1136/bmj.h2335(Published 19 May 2015)Cite this as:BMJ2015;350:h2335

Primary prevention with lipid lowering drugs and long term risk of vascular events in older people: population based cohort study

Abstract
Objective To determine the association between use of lipid lowering drugs (statin or fibrate) in older people with no known history of vascular events and long term risk of coronary heart disease and stroke
Design Ongoing prospective population based cohort study recruited in 1999-2000, with five face-to-face examinations.
Setting Random sample of community dwelling population aged 65 years and over, living in three French cities (Bordeaux, Dijon, Montpellier).
Participants 7484 men and women (63%) with mean age 73.9 years and no known history of vascular events at entry. Mean follow-up was 9.1 years.
Main outcome measures Adjusted hazard ratios of coronary heart disease and stroke in baseline lipid lowering drug users compared with non-users, calculated using multivariable Cox proportional hazard models adjusted for numerous potential confounding factors.Hazard ratios were estimated for use of any lipid lowering drug and for statin and fibrate separately.
Results Lipid lowering drug users were at decreased risk of stroke compared with non-users (hazard ratio 0.66, 95% confidence interval 0.49 to 0.90); hazard ratios for stroke were similar for statin (0.68, 0.45 to1.01) and fibrate (0.66, 0.44 to 0.98).No association was found between lipid lowering drug use and coronary heart disease (hazard ratio 1.12, 0.90 to 1.40).Analyses stratified by age, sex, body mass index, hypertension, systolic blood pressure, triglyceride concentrations, and propensity score did not show any effect modification by these variables, either for stroke or for coronary heart disease.
Conclusion In a population based cohort of older people with no history of vascular events, use of statins or fibrates was associated with a 30% decrease in the incidence of stroke.