Open AccessStatins in the Elderly: A Patient‐Focused Approach
Author(s) -
Wilmot Kobina A.,
Khan Abdullah,
Krishnan Sandeep,
Eapen Danny J.,
Sperling Laurence
Publication year - 2015
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22338
Subject(s) - medicine , polypharmacy , statin , randomized controlled trial , stroke (engine) , population , intensive care medicine , physical therapy , gerontology , environmental health , mechanical engineering , engineering
Individuals age >65 years represent the fastest‐growing subpopulation in the United States. Although these individuals with the highest cardiovascular risk profile would be anticipated to be the most aggressively treated, paradoxically, treatment and baseline risk are inversely related. Presumably, the elderly population would benefit from high‐intensity statin therapy; however, as per the 2013 American College of Cardiology/American Heart Association guidelines, given the scarcity of evidence in patients age >75, there are only sufficient data from randomized controlled trials to support use of moderate‐intensity statin therapy for secondary prevention. Despite evidence demonstrating statins are beneficial in the elderly, the decision to initiate and sustain treatment should be a well‐informed and collaborative decision. One must balance the benefits (secondary atherosclerotic cardiovascular prevention, stroke reduction, decreased morbidity and mortality) with the potential risks to the elderly (altered metabolism, comorbidities, polypharmacy and drug‐drug interactions, side effects, cognitive limitations, and cost).