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 and judiciously in prima...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research