Open AccessLipid-Lowering Therapy for Primary Cardiovascular Prevention in Older Adults. Consensus Statement of the Russian Association of Gerontologists and Geriatricians, National Society on Atherosclerosis, Russian Society of Cardiology, Association of Clinical Pharmacologists
Author(s) -
Yu. V. Kotovskaya,
О. Н. Ткачева,
И. В. Сергиенко
Publication year - 2020
Publication title -
kardiologiâ
Language(s) - English
Resource type - Journals
eISSN - 2412-5660
pISSN - 0022-9040
DOI - 10.18087/cardio.2020.6.n1037
Subject(s) - medicine , pharmacotherapy , cholesterol , geriatrics , gerontology , intensive care medicine , physical therapy , psychiatry
Completed randomized clinical studies did not have a sufficient statistical power for demonstrating clearly the efficacy of lipid-lowering therapy for primary prevention in patients aged 75 years and older and did not evaluate the effect of lipid-lowering therapy on development and course of key geriatric syndromes. Age-related alterations of skeletal muscles, cognitive decline, senile asthenia, comorbidities, polypragmasy, potential changes in drug pharmacokinetics and pharmacodynamics, and impaired renal function may adversely affect the benefit to harm ratio of statins in older patients. Key questions for administration of a lipid-lowering therapy for primary prevention in patients aged 75 years and older are: 1. Does the relationship between increased low-density lipoprotein cholesterol (LDL CS) and death rate persist? 2. Does a benefit from decreasing the level of LDL CS persist? 3. Is the lipid-lowering therapy safe? 4. What scales for risk stratification and determining indications for lipid-lowering therapy should be used?