Impact of Average Daily and Cumulative Dose of Statins on Mortality Risk Among Healthy Elderly

We read with much interest the recently published paper in your journal entitled “Real-life benefits of statins for cardiovascular prevention in elderly subjects: a population-based cohort study.”1 It is a well-designed study, which reported that statin treatment was not associated with a reduction in acute coronary syndrome or all-cause death in elderly patients treated in primary prevention without modifiable risk factors. But, despite reporting the data on the various daily doses of statins dispensed in each group of patients (eTable 3 of the paper), the authors did not investigate the effect of average daily or cumulative dose of statins on cardiovascular mortality risk, which we believe could elucidate the true association between statin use and mortality risk in an elderly population.