Hypercholesterolaemia in the elderly: is drug treatment justified?
Total serum cholesterol levels are strongly positively correlated with the incidence of coronary heart disease (CHD) in middle-aged populations. This correlation is strongest in the most premature cases of CHD (below age 40 years), but diminishes with increasing age. According to the Framingham study, LDL cholesterol remains a CHD risk factor in the elderly, although with reduced impact, and HDL cholesterol continues to be a significant protective factor even in old age. The reduced impact of LDL cholesterol as a risk factor for CHD has been taken to indicate that drug treatment of elevated serum cholesterol is not as important in the elderly as in the middle-aged population. Until now, this and possible adverse drug effects have provided a rationale for non-intervention in the older age groups. However, the emergence of powerful new agents with LDL cholesterol-lowering and HDL-cholesterol-increasing effects (HMG CoA reductase inhibitors), characterized by excellent patient compliance, suggests that drug therapy may be useful for selected elderly patients.
Tikkanen
M J
MJ
Third Department of Medicine, University of Helsinki, Finland.
D000367:Age Factors; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011973:Receptors, LDL / Q000378:metabolism; D012307:Risk Factors
D000924:Anticholesteremic Agents; D011973:Receptors, LDL