Lipid-lowering therapy for the primary prevention of cardiovascular disease in the elderly: opportunities and challenges.
Although HMG-CoA reductase inhibitors (statins) have been shown to reduce the risk of cardiovascular events in patients aged 65-80 years who have clinical cardiovascular disease, fewer data are available for elderly patients without cardiovascular disease. Treatment guidelines recommend a low-density lipoprotein cholesterol goal of <100 mg/dL for those with cardiovascular disease or diabetes mellitus but vary in their recommendations for primary prevention. Moderate-dose statins have been shown to be effective and safe in properly selected elderly patients up to the age of 80 years. High-dose statins have also been shown to be effective and reasonably safe in patients without significant co-morbidities up to the age of 75 years. With advancing age, the potential for benefit from cholesterol-lowering treatment needs to be weighed against the increasing risk of muscle and hepatic toxicity, as well as competing causes of morbidity and mortality.
Lipid Research Clinic, Departments of Epidemiology & Medicine, University of Iowa, Iowa City, Iowa 52242, USA. jennifer-g-robinson@uiowa.edu
Jennifer G
JG
Robinson
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control* / Q000523:psychology; D008078:Cholesterol, LDL / Q000378:metabolism; D002986:Clinical Trials as Topic; D003071:Cognition / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology; D050356:Lipid Metabolism / Q000187:drug effects*
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors