In Reply Shared decision making is a cornerstone of optimal geriatric care, especially when it comes to deciding on a lifelong treatment for which the available data do not fully allow for an evidence-based decision. As Drs Stone and Blum suggest, the ACC-AHA guidelines1 and our Viewpoint are consistent in suggesting that clinicians follow a shared decision-making approach in discussing the use of statins for primary prevention in adults older than 75 years. Although the risk estimator (http://tools.acc.org/ASCVD-Risk-Estimator/) may be used in the context of a risk-benefit discussion between the patient and physician, the problem is that in the absence of good evidence supporting the net clinical benefit of treatment, the risk estimator provides limited help to the older patient and the clinician in deciding whether to use a statin for primary prevention.
Gurwitz JH, Go AS, Fortmann SP. Use of Statins in Adults Older Than 75 Years—Reply. JAMA. 2017;317(10):1081. doi:10.1001/jama.2017.0385