Preventing the next event in the elderly: the PROSPER perspective.
Statins reduce coronary and cerebrovascular morbidity and mortality in middle-aged individuals but their efficacy and safety in elderly people has not been confirmed. Several clinical trials including the Cholesterol and Recurrent Events (CARE) and Long-term Intervention with Pravastatin in Ischemic Disease (LIPID), have sub-analysed their results for the 'elderly' cohort, but the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) trial is the first trial to specifically evaluate the benefits of statin therapy on vascular risk in elderly men and women. The results have shown that pravastatin, given for 3 years, reduced the risk of coronary heart disease in elderly individuals. Within this same time frame, there was no significant benefit on the risk reduction of stroke but there was a trend to reduce the risk of transient ischemic attacks. It was discovered that those patients with the lowest baseline high-density lipoprotein cholesterol gained the most benefit from the intervention. Drug interactions between pravastatin and the concomitant medications seen in this elderly cohort, was not a significant clinical issue. Therefore, PROSPER extends to elderly individuals the treatment strategy currently used in middle-aged people.
Shepherd
James
J
Department of Pathological Biochemistry, University Department of Pathological Biochemistry, Royal Infirmary, Glasgow, G4 0SF, Scotland, UK. jshepherd@gri-biochem.org.uk
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000517:prevention & control*; D003327:Coronary Disease / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D017035:Pravastatin / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017035:Pravastatin