Role of Statin Therapy in Primary Prevention of Cardiovascular Disease in Elderly Patients

AbstractPurpose of ReviewHypercholesterolemia and statin treatment are nowadays common among people older than 75  years, but clinical heterogeneity in this increasing age group is wide, and treatment decisions may differ from those in younger patients. Aim is to discuss the presentation, modifying factors, and treatment decisions of hypercholesterolemia (usually with statins) in older persons and focusing on primary prevention.Recent FindingsThere are no randomized controlled trials in persons older than 80  years at baseline. Randomized controlled trial findings in younger patients and 75+ subgroups and in observational studies support treatment in secondary prevention of atherosclerotic cardiovascular disease (ASCVD), but trial evidence in primary prevention is less clear. Available data do not impl y specific harms in older patients, and, therefore, also, judicious primary prevention is possible. However, persons older than 75 years are biologically a very heterogeneous group with frequent frailty, comorbid conditions, and multiple concomitant drugs. All these, as well as personal preferences , must be taken into account in treatment decisions.SummaryStatin treatment is only one way to prevent ASCVD in older people. Treatment of hypercholesterolemia should be started far before 75 –80 years, and there is no need to discontinue statin treatment due to chronological age alone. After 75 years, treatment should be started in patients with ASCVD ...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research

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CONCLUSION: Polypharmacy was strongly associated with dyspnea. Prospective interventions to decrease polypharmacy may impact dyspnea symptoms, especially for statins. PMID: 31550901 [PubMed - as supplied by publisher]
Source: The American Journal of Hospice and Palliative Care - Category: Palliative Care Authors: Tags: Am J Hosp Palliat Care Source Type: research
CONCLUSION: A substantial share of older persons with life-limiting diseases receive drugs of questionable clinical benefit during their last months of life. Adequate training, guidance and resources are needed to rationalize and deprescribe drug treatments for older adults near the end of life. PMID: 31172885 [PubMed - as supplied by publisher]
Source: Palliative Medicine - Category: Palliative Care Authors: Tags: Palliat Med Source Type: research
by Michael Pottash (@mpottash)Comfort Care, whatever does that mean? This is the important question asked by my colleagues Anne Kelemen and Hunter Groninger in the September 2018 issue of JAMA Internal Medicine. The term is ubiquitous and its interpretation influences how patients with end stage illness are cared for at the end of their lives. In their article they argue that the language of Comfort Care is confusing and easily misunderstood. They suggest improving the understanding around end of life care and moving to a less ambiguous term for care of the dying. I worry that any term to describe dying care will always be...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: comfort hospice hospital icu JAMA Internal Medicine palliative care pottash The profession Source Type: blogs
Journal of Palliative Medicine,Volume 22, Issue 3, Page 351-351, March 2019.
Source: Journal of Palliative Medicine - Category: Palliative Care Source Type: research
AbstractBackgroundStatins are often discontinued in patients with advanced cancer since the net effect of treatment is considered negative. However, guidelines concerning discontinuation of statin treatment are lacking. The aim of this study was to investigate any differences in time of discontinuation of statin treatment between men and women with advanced cancer disease.MethodsMedical records from 195 deceased palliative cancer patients from a previous study cohort were reviewed. Patients treated with statins 2  years before death were identified as “statin users.” The time of discontinuation of statin t...
Source: Biology of Sex Differences - Category: Biology Source Type: research
by Drew RosielleWe have a'required reading'list for our fellowship, which includes a bunch of what I think are landmark or otherwise really important studies. One of them is thisvery well done RCT of continuous ketamine infusions for patients with cancer pain, which showed it to be ineffective (and toxic).We also recently have seen another high-quality study published with negative results for ketamine. This was a Scottish, multi-center, randomized, placebo-controlled, intention-to-treat, and double-blinded study oforal ketamine for neuropathic pain in cancer patients. The study involved 214 patients, 75% of whom were thro...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: fatigue ketamine methylphenidate neuropathic pain research research issues rosielle The profession Source Type: blogs
Conclusion: Strategies to mitigate readmission rates secondary to HF include limiting LOS to less than 5 days, providing smoking cessation education, and prescribing an ACE-I at the time of discharge. Methods to minimize development of DM and CRF through controlling contributing risk factors and ensuring appropriate management of psychiatric disorders are additional platforms for decreasing readmission rates for HF. Counter to previous assumptions, the discharge time of the day, day of the week, and month of the year did not affect the rate of readmissions, nor did the type of payor, the discharge location, or whether pati...
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session AM Source Type: research
Journal of Palliative Medicine,Volume 21, Issue 3, Page 283-283, March 2018.
Source: Journal of Palliative Medicine - Category: Palliative Care Authors: Source Type: research
Journal of Palliative Medicine,Volume 21, Issue 3, Page 281-282, March 2018.
Source: Journal of Palliative Medicine - Category: Palliative Care Authors: Source Type: research
Journal of Palliative Medicine,Volume 21, Issue 3, Page 283-283, March 2018.
Source: Journal of Palliative Medicine - Category: Palliative Care Authors: Source Type: research
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