title: Statin therapy across the lifespan: evidence in major age groups.
abstract: This review provides needed perspective on statin efficacy and safety in individuals under 40, 40-75, and > 75 years of age. Starting with the 2013 ACC-AHA cholesterol guidelines extensive evidence base on randomized controlled trials (RCTs) we added references in the past 5 years that discussed statin efficacy and safety over the life span. In those under 40, statins are primarily used for treatment of severe hypercholesterolemia, often familial, and they are well tolerated. In middle-aged adults, statins have strong evidence for benefit in primary and secondary prevention trials; however, in primary prevention, a clinician-patient risk discussion should precede statin prescription in order to determine appropriate treatment. In those over 75, issues of statin intensity and net benefit loom large as associated comorbidity, polypharmacy, and potential for adverse effects impact the decision to use statins with RCT data strongest in support of use in secondary prevention. Statin drugs have been studied by RCTs in a large number of individuals. In those groups shown to benefit, statins have reduced the risk of atherosclerotic cardiovascular disease with few side effects as compared to controls. This review has detailed considerations that should occur when statins are given to individuals in different age groups.
authors.affiliation: a Department of Medicine (Cardiology) , Northwestern University , Chicago , IL , USA.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Stone
authors.affiliation: b Department of Medicine , Loyola University Medical Center , Maywood , IL , USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Turin
authors.affiliation: c Feinberg School of Medicine , Northwestern University , Chicago , IL , USA.
authors.forename: Jared A
authors.initials: JA
authors.lastname: Spitz
authors.affiliation: c Feinberg School of Medicine , Northwestern University , Chicago , IL , USA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Valle
authors.affiliation: d Department of Medicine (Cardiology), Clinical Research Associate , Northwestern University , Chicago , IL , USA.
authors.forename: Sakina
authors.initials: S
authors.lastname: Kazmi
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000188:drug therapy*; D002784:Cholesterol / Q000097:blood; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008875:Middle Aged; D011322:Primary Prevention
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol
keywords: HMGCoA reductase inhibitor; Statin; efficacy; elderly; lifetime; middle-aged adults; over 75; safety; under age 40; young