Is aggressive lipid‐lowering effective and safe in the older adult?

With improvements in diet and health care over the last several decades, the elderly have become the fastest‐growing segment of the U.S. population. Along with this progress, however, has come increasing morbidity, much of which is attributable to cardiovascular disease, and which is burdensome both to patients and to the health‐care system. New medications, including HMG‐CoA reductase inhibitors (statins) have the potential to prevent or delay the progression of disease and vascular events. Large, randomized, placebo‐controlled trials continue to show that elderly patients benefit from statin therapy and that aggressive therapy is generally very safe in this population; however, statins remain underused in older individuals. This paper reviews the benefits of statin therapy in the elderly and discusses the reality versus the perception of risk, selection of appropriate patients, and ways in which any risks that may exist can be minimized further.