title: Assessment of the use of hypolipidemic agents (HAs), mainly statins, in elderly subjects aged 80 years and more in Burgundy: analysis of 13,211 patients.
abstract: Only few studies have investigated the use of HA in elderly subjects and there are no data in very elderly subjects. We assessed the prescription of HA and analyzed the relationship between such prescriptions and frailty markers among persons aged 80 and more in an observational study. We recorded the prescriptions for 13,211 patients aged 80-109 years and affiliated to the "Mutualité-Sociale-Agricole (MSA)" of Burgundy over a 1-month period. The prescription of a HA among all included patients, and the existence of serious long-term disease(s) (LTD), polypharmacy or a prescription of cardiovascular drugs among patients receiving a HA were recorder. Among the 13,211 patients, 3412 aged 80-98 years were treated with an HA. The main HA were statins (70.4%), and fibrates were used in 27.3% of cases. Of these 3412 patients, 2250 had one or several LTD mainly coronaropathy, hypertension, diabetes mellitus or peripheral artery disease. The mean number of drugs per prescription was 6.37. Among subjects treated with HA, 40% also received antiplatelets, 35.6% β-blockers and 30% inhibitors of the renin-angiotensin system. For 99% of the patients, the prescription of HA was a renewal. Prescribers were mainly general practitioners (96.8%). Statins are the most widely prescribed HA even among very elderly subjects. However, after 80 years the prescription of HA, mainly statins, decreases with aging. This could be explained by polypathology, polypharmacy and the deterioration in metabolic functions which are markers of frailty. This study should encourage research into the use of statins in very elderly subjects.
authors.affiliation: Service de Médecine Interne Gériatrie, Hôpital de Champmaillot, CHU, 2 rue Jules Violle, F-21079 Dijon Cedex, France. patrick.manckoundia@chu-dijon.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Manckoundia
authors.forename: Mathieu
authors.initials: M
authors.lastname: Lorenzini
authors.forename: Anne
authors.initials: A
authors.lastname: Disson-Dautriche
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Petit
authors.forename: Bernard
authors.initials: B
authors.lastname: Lorcerie
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Debost
authors.forename: Didier
authors.initials: D
authors.lastname: Menu
authors.forename: Pierre
authors.initials: P
authors.lastname: Pfitzenmeyer
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000188:drug therapy; D011307:Drug Prescriptions; D005260:Female; D058607:Fibric Acids / Q000627:therapeutic use; D005602:France; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D058729:Peripheral Arterial Disease / Q000188:drug therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019338:Polypharmacy
chemical_list: D000319:Adrenergic beta-Antagonists; D002317:Cardiovascular Agents; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors