Abstract： Objective:To investigate the effect of atorvastatin and pravastatin on elderly patients with coronary atherosclerotic heart disease(CHD).Methods:A total of 100 patients with CHD aged ≥80 years who were admitted to Geriatrics department of Xiamen Hongai Hospital from September 2018 to February 2019 were selected for retrospective analysis of their clinical data, including 61 males and 39 females, aged(87.50±2.34)years, ranging from 80 to 92 years.Patients were divided into atorvastatin group and pravastatin group according to different treatment methods, with 50 patients in each group.Atorvastatin group received atorvastatin 20 mg/d, pravastatin group received pravastatin 40 mg/d for 12 weeks.After treatment, blood lipid levels[total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein], treatment effects, changes in glutamic-pyruvic transaminase, glutamic-oxalacetic transaminase, creatine kinase, serum creatinine levels and the occurrence of adverse reactions were compared between the two groups.Results:The lipid-lowering effect of atorvastatin group[92.0%(46/50)]was better than pravastatin group[80.0%(40/50)], and the difference was statistically significant( P<0.05). After treatment, there was no significant difference in blood lipid levels between atorvastatin group and pravastatin group( P>0.05). There were no significant differences in alanine aminotransferase, aspartate aminotransferase, creatine kinase and serum creatinine between atorvastatin group and pravastatin group( P>0.05). There was no statistical significance in the occurrence of adverse reactions between 2 groups( P>0.05). Conclusion:Both atorvastatin and pravastatin can effectively treat elderly CHD, and there were no significant differences in the incidence of adverse reactions, blood lipid levels, alanine aminotransferase, aspartate aminotransferase, creatine kinase and serum creatinine levels in patients.