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Lipid-Lowering Therapy for the Primary Prevention of Cardiovascular Disease in the Elderly

Opportunities and Challenges

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Abstract

Although HMG-CoA reductase inhibitors (statins) have been shown to reduce the risk of cardiovascular events in patients aged 65–80 years who have clinical cardiovascular disease, fewer data are available for elderly patients without cardiovascular disease. Treatment guidelines recommend a low-density lipoprotein cholesterol goal of <100 mg/dL for those with cardiovascular disease or diabetes mellitus but vary in their recommendations for primary prevention. Moderate-dose statins have been shown to be effective and safe in properly selected elderly patients up to the age of 80 years. High-dose statins have also been shown to be effective and reasonably safe in patients without significant co-morbidities up to the age of 75 years. With advancing age, the potential for benefit from cholesterol-lowering treatment needs to be weighed against the increasing risk of muscle and hepatic toxicity, as well as competing causes of morbidity and mortality.

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Acknowledgements

This project was supported in part by an Agency for Healthcare Research and Quality Centers for Education and Research on Therapeutics cooperative agreement #5 U18 HSO16094.

Jennifer G. Robinson, MD, MPH, has received institutional (University of Iowa, Iowa City, IA, USA) research contracts from Abbott, Aegerion, Andrx, Astra-Zeneca, Atherogenics, Bristol-Myers Squibb, Daiichi-Sankyo, GlaxoSmithKline, Hoffman La Roche, Merck, Pfizer, Procter & Gamble, Sankyo, Schering-Plough, Takeda and Wyeth Ayerst and honoraria for education programmes from Bristol-Myers Squibb, Merck, Merck-Schering Plough, Pfizer and Reliant, and has acted as a consultant to and/or advisory board member for Astra-Zeneca, Bristol-Myers Squibb, Merck, Pfizer, Proliant, Wellmark and American Emu Association.

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  1. Lipid Research Clinic, Departments of Epidemiology & Medicine, University of Iowa, 200 Hawkins Drive SE 226 GH, Iowa City, Iowa, 52242, USA

    Jennifer G. Robinson

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Robinson, J.G. Lipid-Lowering Therapy for the Primary Prevention of Cardiovascular Disease in the Elderly. Drugs Aging 26, 917–931 (2009). https://doi.org/10.2165/11318270-000000000-00000

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