Stepping up cholesterol-cutting statin treatment can help save the lives of heart disease patients from all age groups, research has shown.
High-intensity use of statins, either by prescribing the most potent drugs or larger doses of less powerful ones, was found to increase survival by 9%.
A similar benefit was seen in both younger patients and those aged 75 to 85.
Statins are very widely used to reduce high levels of blood cholesterol, which is known to contribute to the stiffening and narrowing of arteries.
There are many versions of the drugs, some more potent than others. The new study investigated whether more intense treatment based on the type of medicine and dosage made a difference to death rates among a large group of American heart patients.
Researchers analysed the medical records of 509,766 patients from the US Veterans Affairs Health Care System, which provides hospital services and support to millions of ex-service men and women and their families.
All had been diagnosed with conditions marked by fatty deposits on the walls of major arteries, including those supplying the heart and brain with blood. When these arteries are blocked or narrowed it can lead to heart attacks and strokes.
The patients were aged between 21 and 84, with an average age at the start of the study of 69. Of the total, 30% were receiving high-intensity, 46% moderate-intensity, and 6.7% low-intensity statin therapy.
Death rates were assessed in the course of a single year, between 2013 and 2014.
The overall results, published in the journal Jama Cardiology, showed that patients on high-intensity statins were 9% more likely to be alive at the end of the year than those receiving moderate-intensity treatments.
The same survival benefit was seen in patients over the age of 75, a group little studied in clinical trials.
Within the high-intensity group, participants receiving the maximum possible dose of the drugs had a 10% increased chance of survival compared with those on lower doses.
Lead author Dr Fatima Rodriguez, from Stanford University in the US, said: "The greatest strength of this study is that we used a very large, well-defined clinical cohort.
"The results show that high-intensity statins confer a survival advantage for patients with cardiovascular disease, including older adults."
The next step is to establish why some patients who should be receiving high-intensity statin treatment are not, said the researchers.
While effective, statins can have side effects which may put some patients and doctors off using strong versions of the drugs or higher doses.
Common side effects include headaches, nausea, muscle pain and an increased risk of diabetes. Very rarely, the drugs can trigger a life-threatening muscle-damaging disease.
Commenting on the study, Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: "Heart disease is incurable - we have no way to reverse the furring of the arteries that can lead to a deadly heart attack or stroke. But decades of research, much of it funded by the BHF, show that statins can help save lives by slowing the progression of the disease.
"This large study showed that more intensive statin treatment reduced death rates further than low-intensity or no treatment in people with cardiovascular disease.
"While this research confirms the greater benefit of more intensive treatment, decisions on dosage require conversations between patients and their doctors."