A practical approach to lipid management in the elderly.
Cardiovascular disease (CVD) increases in a curvilinear fashion after 65 years in men and 75 years in women and the majority of all cardiovascular events occur in individuals older then 65 years. There are notable differences in the clinical assessment of hyperlipidaemia, cardiovascular risk estimation as well as the safety and tolerability profiles in the elderly compared to younger individuals. Clinical trial data have now demonstrated the benefits of statin treatment in the elderly in both the primary and secondary prevention settings. There is however limited data for individuals older than 80 years. Little data is available on other lipid modifying medication in the elderly. With continuing increases in average life expectancy, preventive efforts will become increasingly important for preventing morbidity, improving quality of life, and reducing healthcare expenditures for older persons. This emphasizes the importance of clinical decision-making and weighing up the risks and benefits of treatment.
Department of Chemical Pathology, Lister Hospital, Stevenage, Hertfordshire SG1 4AB, UK. adie.viljoen@nhs.net
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Viljoen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005260:Female; D005102:Health Expenditures; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012307:Risk Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents
N Engl J Med. 1998 Nov 5;339(19):1349-57
9841303
Int J Clin Pract. 2008 Sep;62(9):1300-3
18793372
Clin Chem. 2001 Sep;47(9):1579-96
11514391
N Engl J Med. 2007 Nov 22;357(21):2109-22
17984165
JAMA. 1975 Jan 27;231(4):360-81
1088963
J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S83-9
15758665
Int J Clin Pract. 2004 Jul;58(7):706-13
15311728
Lancet. 2005 Nov 19;366(9499):1773-83
16298214
Am J Cardiol. 2006 Apr 17;97(8A):52C-60C
16581329
Circulation. 2002 Apr 9;105(14):1735-43
11940556
Lancet. 2007 Nov 24;370(9601):1781-90
17559928
JAMA. 2007 Jul 18;298(3):336-8
17635897
Circulation. 2002 Dec 17;106(25):3143-421
12485966
Int J Clin Pract. 2008 Apr;62(4):518-20
18324945
Lancet. 2007 Dec 1;370(9602):1829-39
18061058
N Engl J Med. 2008 Nov 20;359(21):2195-207
18997196
Ann Epidemiol. 2004 Oct;14(9):705-21
15380802
Curr Med Res Opin. 2003;19(3):155-68
12814127
Clin Chem. 1992 Jan;38(1):150-60
1733589
N Engl J Med. 1996 Oct 3;335(14):1001-9
8801446
Int J Clin Pract. 2006 Apr;60(4):442-9
16620358
BMJ. 2009 Jun 30;338:b2376
19567909
Clin Chem. 2009 Mar;55(3):407-19
19168552
Lancet. 2005 Oct 8;366(9493):1267-78
16214597
Clin Chim Acta. 2002 Sep;323(1-2):73-87
12135808
Circulation. 1997 Dec 16;96(12):4211-8
9416884
Clin Chem. 1972 Jun;18(6):499-502
4337382
Int J Clin Pract. 2008 Oct;62(10):1470-3
18822020
Am J Prev Med. 2005 Dec;29(5 Suppl 1):164-8
16389144
JAMA. 2004 Dec 1;292(21):2622-31
15572720
Lancet. 1994 Nov 19;344(8934):1383-9
7968073
World J Gastroenterol. 2003 Nov;9(11):2622-6
14606112
Proteomics. 2005 Feb;5(2):551-65
15627967
Int J Clin Pract. 2009 Jan;63(1):3-6
19125986
Lancet. 2002 Jul 6;360(9326):7-22
12114036
Lancet. 2002 Nov 23;360(9346):1623-30
12457784
JAMA. 2005 Sep 14;294(10):1255-9
16160134
J Clin Invest. 2007 Mar;117(3):595-8
17332889
N Engl J Med. 2005 Jan 6;352(1):73-5
15635116
Stroke. 2007 Feb;38(2):441-50
17194877
N Engl J Med. 2009 Apr 30;360(18):1851-61
19329822
J Clin Endocrinol Metab. 2007 May;92(5):1581-9
17483372
Heart. 2005 Dec;91 Suppl 5:v1-52
16365341
Lancet. 2007 Jan 20;369(9557):168-9
17240267
N Engl J Med. 1988 Jul 7;319(1):24-33
3288867
Ann Intern Med. 2001 May 15;134(10):931-40
11352694
N Engl J Med. 1995 Nov 16;333(20):1301-7
7566020
Lancet. 2004 Aug 21-27;364(9435):685-96
15325833
Ann Intern Med. 1997 May 15;126(10):753-60
9148647
Ann Intern Med. 1961 Jul;55:33-50
13751193
J Clin Invest. 2007 Mar;117(3):746-56
17332893