Management of hypercholesterolemia in older persons for the prevention of cardiovascular disease.
Multiple randomized, double-blind, placebo-controlled studies and observational studies have demonstrated that statins decrease mortality and major cardiovascular events in high-risk persons with hypercholesterolemia. The Heart Protection Study showed that statins decreased mortality and major cardiovascular events in high-risk persons regardless of the initial level of serum lipids, age, or gender. The updated National Cholesterol Education Program III guidelines state that in very high-risk patients, a serum low-density lipoprotein (LDL) cholesterol level of <70 mg/dL is a reasonable clinical strategy, regardless of age. When a high-risk person has hypertriglyceridemia or low serum high-density lipoprotein cholesterol, consideration can be given to combining a fibrate or nicotinic acid with an LDL cholesterol-lowering drug. For moderately high-risk persons, the serum LDL cholesterol should be lowered to <100 mg/dL. When LDL cholesterol-lowering drug therapy is used to treat high-risk persons or moderately high-risk persons, the serum LDL cholesterol should be reduced at least 30% to 40%. High-risk older persons should be treated with lipid-lowering drug therapy according to National Cholesterol Education Program III updated guidelines to decrease cardiovascular morbidity and mortality. The LDL cholesterol should be decreased to <160 mg/dL in persons at low risk for cardiovascular disease.
Aronow
Wilbert S
WS
Department of Medicine, Division of Cardiology, New York Medical College/Westchester Medical Center, Valhalla, NY 10595, USA. WSAronow@aol.com
Frishman
William H
WH
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003131:Combined Modality Therapy; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male
D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents