In a recent clinical study, researchers have suggested that statins could play a key role in reducing dementia in individuals with heart failure (HF). The study, published in the Lancet Regional Health, aimed to investigate the association between statin therapy and the risks of dementia among patients with HF.
Dementia poses a significant comorbidity burden in aged individuals, with approximately 46.8 million cases globally. Similarly, over 64 million individuals worldwide bear the burden of HF, with its prevalence continuing to rise. Common pathological mechanisms and risk factors are shared between heart failure and dementia, with some studies indicating that HF inherently contributes to the development of dementia. As a result, the focus of HF outcomes has shifted to non-cardiovascular comorbidities, with dementia taking precedence.
Despite the high prevalence of both conditions, there is a lack of studies exploring interventional strategies to address the dementia burden in patients with HF. Several meta-analyses have shown that statin use is associated with a lower risk of all-cause dementia in a dose-response manner. Statins exert their effects through various mechanisms, including lipid-lowering, ameliorating inflammation, and reducing amyloid precursor proteins. However, previous studies have rarely evaluated the effects of statin use on dementia incidence among patients with HF, particularly in Asian patients, which could have clinical relevance.
For the retrospective cohort study, researchers identified all patients aged 18 years and above with HF as the primary diagnosis during their hospitalization between 2004 and 2018, using the Clinical Data Analysis and Reporting System (CDARS) database developed by the Hong Kong Hospital Authority. Among the 104,295 patients meeting the criteria, 54,004 were statin users, and 50,291 were non-users after the index date, i.e., the date of the first HF diagnosis. The study analyzed the use of four types of statins: simvastatin, atorvastatin, rosuvastatin, and fluvastatin, and their effects on the risks of three types of dementia: Alzheimer’s disease (AD), vascular dementia, and unspecified dementia. Additionally, patients were categorized based on their low-density lipoprotein-cholesterol (LDL-C) levels to calculate their time-weighted average LDL-C level, aiding the researchers in understanding the impact of lipid control on the association between statin use and dementia risks in patients with HF.
