[Treatment with hydroxymethylglutaryl coenzyme-A-reductase inhibitors in elderly patients: is it necessary?].
OBJECTIVE
To study the benefit of the therapy with hydroxymethylglutaryl coenzyme A reductase inhibitors (simvastatin) associated with diet in treating dyslipidemia in elderly patients, considering that they are more exposed to sudden death, myocardial infarction and stroke. Efficient and long-term serum cholesterol concentration lowering has beneficial effects on the risk for coronary heart disease as well as on other major cardiovascular risk factors such as hypertension and diabetes.


METHODS
A retrospective study of 84 patients aged > or = 65 years, admitted in the last 6 months in Medical Clinic IV, was conducted. Admission criteria in the study were: age > or = 65 years old and high serum levels of cholesterol, triglycerides and LDL-C/HDL-C ratio. The patient population was divided into two groups: Group I of 40 patients treated for dyslipidemia only with diet and Group II with 44 patients in which was associated treatment with hydroxymethylglutaryl coenzyme A reductase inhibitors, 10 mg/day. The patients were controlled when admitted in the study and then at 3 and 6 weeks afterwards.


RESULTS
Serum cholesterol and triglycerides concentration lowering was modest in Group I at 3 and 6 weeks, maybe because we registered a progressively lowered compliance of patients to hypocholesterolemic diet. In Group II the results were much better as we obtained significant serum cholesterol and triglycerides levels lowering after 3 weeks of treatment, and in 32 cases (72%) we had a normal lipid profile after 6 weeks of treatment. The other 12 patients (28%) abandoned treatment after 4 weeks of therapy because of financial reasons. There were no side effects during the treatment with hydroxymethylglutaryl coenzyme A reductase inhibitors.


CONCLUSIONS
The therapy with hydroxymethylglutaryl coenzyme A reductase inhibitors associated to hypocholesterolemic diet controlled efficiently dyslipidemia in elderly patients. Diet alone could not control cholesterol and triglycerides levels, mainly because of lack of adherence of the patients to the diet. Based on the fact that dyslipidemia is a major, independent cardiovascular risk factor, we consider that therapy with hydroxymethylglutaryl coenzyme-A-reductase inhibitors is beneficial in elderly patients because of their efficacity, minimal side effects and protection against sudden death, myocardial infarction and stroke.
Alexa
Ioana Dana
ID
Facultatea de Medicină, Clinica a IV-a Medicală-Nefrologie, Universitatea de Medicină si Farmacie "Gr. T. Popa", Iaşi.
Panaghiu
Larisa
L
Ungureanu
G
G
D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D003327:Coronary Disease / Q000517:prevention & control; D003645:Death, Sudden / Q000517:prevention & control; D050171:Dyslipidemias / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000517:prevention & control; D019821:Simvastatin / Q000627:therapeutic use*; D020521:Stroke / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D019821:Simvastatin