title: Statins for the primary prevention of cardiovascular disease in the elderly.
abstract: OBJECTIVE
  The objective is to review the evidence evaluating the efficacy of statin therapy for primary prevention of cardiovascular (CV) disease in the elderly.
  
  
  METHODS
  A literature search of MEDLINE and PubMed (1966-January 2013) using the terms HMG-CoA reductase inhibitor, statin, primary prevention, elderly, and geriatrics was performed. The search was limited to clinical trials, meta-analyses, and subanalyses, including primary prevention patients. Bibliographies of selected articles were examined to identify additional clinical trials.
  
  
  METHODS
  Fourteen clinical trials, subanalyses, and meta-analyses were reviewed. A total of seven clinical trials and subanalyses evaluating statin therapy versus placebo in the elderly primary prevention patients with a primary endpoint of hard coronary heart disease were included.
  
  
  METHODS
  Data collected from the clinical trials and subanalyses included number of elderly patients randomized, therapy, duration of follow-up, and the incidence of coronary events.
  
  
  RESULTS
  The average annual rates of first CV event increases as patients age. There is strong evidence that supports the use of statins for secondary prevention; although primary prevention, specifically in the elderly, is less defined. This paper reviews the literature specifically for primary prevention, for which the results have shown a trend toward decreased first occurrence of coronary heart disease with statin therapy in elderly patients.
  
  
  CONCLUSIONS
  Statin therapy should be considered as a primary prevention therapy against coronary disease for elderly patients. Evidence-based clinical benefits are seen in this patient population. However, clinical judgment and consideration of comorbidities that may impact life expectancy should be assessed to determine appropriateness for individual patients.
authors.affiliation: Department of Clinical and Administrative Sciences, California Northstate University College of Pharmacy, Elk Grove, California, USA.
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Lowe
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Vande Griend
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Saseen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011322:Primary Prevention / Q000379:methods*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors