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To the Editor: Dr Ko and colleagues¹ reported that the probability of receiving statin treatment actually decreases with increasing age and baseline risk for coronary heart disease. The authors defined baseline risk as the probability of death from any cause within 3 years. In high-risk older patients, death can be considered as a competing risk, and it has been recommended that limited life expectancy be factored into the creation of health care plans.^2-3 Usually, death from cardiovascular disease is the most common form of an event that removes the risk of a different event. In this case, death from any cause can compete with the probability of benefit from statin therapy.

Ko et al reported 60% three-year mortality in their highest-risk subgroup. In the United States the average life expectancy of an individual who reaches the age of 95 years is still 3.6 years,⁴ suggesting that most high-risk older individuals . . . [Full Text of this Article]

Carlos O. Weiss, MD
cweiss9@jhmi.edu

Ravi Varadhan, PhD
Johns Hopkins Center on Aging and Health
Baltimore, Md

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