Treatment With Statins In Elderly Patients

Potential harms is a crucial part of appropriate decision making. So while a statin may help 1 in 45 patients taking a statin to prevent a heart attack over 2-3 years over 15 years it may help 1 in 10 patients a better ratio.

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Although statins have become with good reason the preferred agents for the treatment of elevated levels of circulating lipids particularly low-density lipoprotein LDL cholesterol LDL-C there are other older agents that can be prescribed in statin-intolerant patients.

Treatment with statins in elderly patients. Statins work by preventing the liver from making excess cholesterol. Multiple RCTs have established the efficacy of statin therapy for primary prevention in patients age 75 years derived from subgroup analyses of larger studies. One the conclusion that in old patients an increased adherence to statin treatment is accompanied by a reduction of all-cause and CV mortality from a good to a very poor and frail clinical condition applied to different age strata up to patients aged 85 years in whom a 7-year mortality rate of 76 made their frail condition incontrovertible.

Treatment differences between highrisk older and younger patients with atherosclerotic cardiovascular disease may represent a therapeutic opportunity for improvement and highlight the importance of future randomized controlled trials evaluating highintensity statin use in older adults for secondary prevention. There is debate on the value of statins in people aged 75 years and older especially for primary prevention of CV events particularly due to the lack of evidence of their efficacy in this population potential compliance-related events drugdrug interactions and side effects that could impair the QOL of patients in this age group who are treated with statins 212223242526272829. As frailty comorbidity and polypharmacy may increase the risk for adverse statin-associated symptoms the risk-benefit balance in the elderly could theoretically tip in favor of withholding statin therapy if such conditions are present.

Seventeen trials were analyzed. Results Only 75 617 patients 191 in this secondary prevention cohort were prescribed statins. In patients age 75 and younger the efficacy of statins for primary prevention is well-established on the basis of multiple randomized trials which have found that they reduce the relative risk of major vascular events by 20-30.

The most efficient treatment against atherosclerosis is the treatment with statins that has been shown to decrease the risk both of stroke and coronary artery disease in all age groups. The main goal of primary prevention with statins is to achieve net-benefit from treatment. However most studies showing that.

Statins confer no benefit over months unless you just had a heart attack or stroke. The likelihood of statin prescription was 64 lower adjusted odds ratio 094. The most commonly used medicines to lower LDL are the statins including atorvastatin Lipitor and rosuvastatin Crestor among many others.

In patients 66 to 74 years old the adjusted probabilities of statin prescription were 377 267 and 234 in the categories of low intermediate and high baseline risk respectively. For all patients with established CVD statins should be prescribed with a lower is better approach to achieve values of at least. In elderly individuals the efficacy of statins remains controversial and the comparative effect of statins has not been assessed.

10 rows Two large studies of primary prevention that included significant numbers of. Accessed May 5 2019. The incidence and prevalence of atherosclerosis increase with age and the number of cardiovascular events is higher in elderly patients.

The advantages of the treatment become evident after. Statins are much more effective over decades. 95 confidence interval 093-095 for each year of in-.

In patients 66 to 74 years old the adjusted probabilities of statin pre-scription were 377 267 and 234 in the categories of low intermediate and high baseline risk respectively. The benefit of statins in prevention of ASCVD events in older adults. Treatment with statins in the elderly population is not associated with accelerated memory dysfunction greater decline in global cognitive function or brain volume changes over 2.

23 Given the paucity of adults 70 years in clinical trials the evidence for the efficacy of statins for primary prevention in older adults is limited. Statins in persons at low risk of cardiovascular disease. When used for secondary prevention statins were associated with reduced risk.

Statin therapy for the very elderly 80 with ASCVD. Statin therapy produces significant reductions in major vascular events irrespective of age but there is less direct evidence of benefit among patients older than 75 years who do not already have evidence of occlusive vascular disease. MEDLINE Embase and the Cochrane Central database were searched for randomized controlled trials that assessed statins in older patients.

The meta-analysis by the Cholesterol Treatment Trialists Collaboration found that statins reduced vascular events irrespective of age including in people older than 75 years although in the primary prevention setting among people older than 75 years there is less evidence of the effects of statin therapy 3. This limitation is now being addressed by further trials. Thresholds for treatment with statins based on 10-year CVD risk will be informed by National Institute for Health and Care Excellence NICE guidelines.

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