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Chapter 31 - Lipid management in older patients

from Section III - Care of the elderly by organ system

Published online by Cambridge University Press:  05 June 2016

Jan Busby-Whitehead
Affiliation:
University of North Carolina
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Samuel C. Durso
Affiliation:
The Johns Hopkins University School of Medicine
Daniel Swagerty
Affiliation:
University of Kansas
Laura Mosqueda
Affiliation:
University of Southern California
Maria Fiatarone Singh
Affiliation:
University of Sydney
William Reichel
Affiliation:
Georgetown University, Washington DC
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Summary

Appropriate lipid management in older patients provides an important opportunity to address cardiovascular risk. In light of the recent update in the cholesterol treatment guidelines, clinicians are encouraged to apply both evidence from clinical trials and additional judgment in treating older individuals. Included in this approach to reducing the burden of cardiovascular disease are considerations of combining medical therapy with an important emphasis on lifestyle to assist in care for older individuals. Given the influence of age on cardiovascular risk and associated comorbidities in this population, the balance between risk and benefit is central to appropriate clinical decision making
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 436 - 445
Publisher: Cambridge University Press
Print publication year: 2016

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References

Stone, N, Robinson, J, Lichtenstein, AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:51545.Google Scholar
Enos, WF, Holmes, RH, Beyer, J. Coronary disease among United States soldiers killed in action in Korea. JAMA 1953;152:1090–3.Google Scholar
Berenson, GS, Wattigney, WA, Tracy, RE, et al. Atherosclerosis of the aorta and coronary arteries and cardiovascular risk factors in persons ages 6 to 30 years and studied at necropsy (the Bogalusa Heart Study). American Journal of Cardiology 1992;70:851–8.CrossRefGoogle Scholar
Cohen, JC, Boerwinkle, E, Mosley, TH Jr, Hobbs, HH. Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N Eng J Med. 2006;354(12):1264–72.Google Scholar
Brown, M, Goldstein, J. Lowering LDL – not only how low, but how long? Science 2006;311(5768):1721–3.Google Scholar
Ference, BA, Yoo, W, Alesh, I, et al. Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a Mendelian randomization analysis. J Am Coll Cardiol. 2012;60(25):2631–9.Google Scholar
National Cholesterol Education Program; National Heart, Lung, and Blood Institute; National Institutes of Health. Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. NIH Publication No. 02–5215. Bethesda, MD: National Cholesterol Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health, 2002.Google Scholar
Persell, SD, Lloyd-Jones, DM, Baker, DW. National Cholesterol Education Program risk assessment and potential for risk misclassification. Prev Med. 2006;43(5):368–71.Google Scholar
Kostis, JB. Disputation on the use of age in determining the need for treatment of hypercholesterolemia and hypertension. J Clin Hypertension 2006;8(7):519–20.CrossRefGoogle ScholarPubMed
Yusuf, S, Hawken, S, Ounpuu, S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEARTstudy): case-control study. Lancet 2004;364:937–52.Google Scholar
Kuller, LH, Arnold, AM. 10-year follow-up of subclinical cardiovascular disease and risk of coronary heart disease in the Cardiovascular Health Study. Arch Intern Med. 2006;166:71–8.CrossRefGoogle ScholarPubMed
Pencina, MJ, Navar-Boggan, AM, D’Agostino, RB Sr, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014;370:1422–31.CrossRefGoogle ScholarPubMed
Grundy, SM, Cleeman, JI. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. J Am Coll Cardiol. 2004;44:720–32.CrossRefGoogle ScholarPubMed
LeMaitre, R, Psaty, BM, Heckbert, SR, et al. Therapy with hydroxylmethylglutaryl coenzyme A reductase inhibitors (statins) and associated risk of incident cardiovascular events in older adults: evidence from the Cardiovascular Health Study. Arch Int Med. 2002;162:13951400.Google Scholar
Strandberg, TE, Pyörälä, K, Cook, TJ, et al. Mortality and incidence of cancer during 10-year follow-up of the Scandinavian Simvastatin Survival Study (4S). Lancet 2004;364(9436):771–7.CrossRefGoogle ScholarPubMed
Bulbulia, R, Armitage, J. Does the benefit from statin therapy extend beyond 5 years? Curr Atheroscler Rep. 2013;15(2):297.CrossRefGoogle Scholar
Cholesterol Treatment Trialists’ (CTT) Collaborators, Mihaylova, B, Emberson, J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012;380(9841):581–90.Google Scholar
Huddy, K, Dhesi, P, Thompson, PD. Do the frequencies of adverse events increase, decrease, or stay the same with long-term use of statins? Curr Atheroscler Rep. 2013;15(2):301.CrossRefGoogle ScholarPubMed
Glynn, RJ, Koenig, W, Nordestgaard, B. Rosuvastatin for primary prevention in older individuals with high C-reactive protein and low LDL levels: exploratory analysis of a randomized trial. Ann Intern Med. 2010;152(8):488–96, W174.Google Scholar
Pederson, T, for the Scandinavian Simvastatin Survival Study Group.Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344(8934);1383–9.Google Scholar
Sacks, FM, Pfeffer, MA, Moye, LA, et al., for the Cholesterol and Recurrent Events Trial Investigators. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med. 1996;335:1001–9.Google Scholar
Hunt, D, Young, P, Simes, J, et al. Benefits of pravastatin on cardiovascular events and mortality in older patients with coronary heart disease are equal to or exceed those seen in younger patients: results from the LIPID trial. Ann Intern Med. 2001;134:931–40.Google Scholar
Afilalo, J, Duque, G, Steele, R, et al. Statins for secondary prevention in elderly patients: a hierarchical bayesian meta-analysis. J Am Coll Cardiol. 2008;51(1):3745.Google Scholar
Aronow, WS. Drug treatment of peripheral arterial disease in the elderly. Drugs Aging 2006;23(1):112.CrossRefGoogle ScholarPubMed
Sacco, R, Adams, R, Albers, G, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke. Stroke. 2006;37:577617.CrossRefGoogle ScholarPubMed
The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549–59.Google Scholar
Eckel, R, Jakicic, J, Ard, J, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk. Circulation. 2014;129(25 Suppl 2):S76S99.Google Scholar
US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Washington, DC: US Department of Health and Human Services; 2008:161. Available at: www.health.gov/PAGuidelines.Google Scholar
Rosenson, RS. Current overview of statin-induced myopathy. Am J Med. 2004;116:408–16.Google Scholar
Hey-Hadavi, JH, Kuntze, D, Luo, D. Tolerability of atorvastatin in a population aged > or = 65 years: a retrospective pooled analysis of results from fifty randomized clinical trials. Am J Geriatr Pharmacother. 2006;4:112–22.CrossRefGoogle Scholar
Finegold, J, Manisty, C, Goldacre, B, et al. What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice. Eur J Prevent Cardiol. 2014:21(4):464–74.Google Scholar
Chia, L, Schlenk, EA. Effect of personal and cultural beliefs on medication adherence in the elderly. Drugs Aging 2006;23(3):191202.Google Scholar
Higashi, T, Shekelle, PG, Solomon, DH, et al. The quality of pharmacologic care for vulnerable older patients. Ann Intern Med. 2004;140:714–20.Google Scholar
Ayanian, JZ, Landrum, MB, McNeil, BJ. Use of cholesterol-lowering therapy by elderly adults after myocardial infarction. Arch Intern Med. 2002;162:1013–19.CrossRefGoogle ScholarPubMed
Ko, DT, Mamdani, M, Alter, D. Lipid-lowering therapy with statins in high-risk elderly patients: the treatment-risk paradox. JAMA 2004;291:1864–70.Google Scholar
Dewilde, S, Carey, IM, Bremner, SA, et al. Evolution of statin prescribing 1994–2001: a case of agism but not of sexism? Heart 2003;89:417–21.Google Scholar
Brenner, JS, Glynn, RJ, Mogun, H, et al. Long-term persistence in use of statin therapy in elderly patients. JAMA 2002;288:445–56.Google Scholar
O’Connor, P. Improving medication adherence: challenges for physicians, payers, and policy makers. Arch Intern Med. 2006;166:1802–4.Google Scholar
Munn, M, Woodard, M, Munter, P. Predictors of non-adherence to statins: a systematic review and meta-analysis. Ann Pharmacother. 2010;44(9):1410–21.Google Scholar
Osterberg, L, Blaschke, T. Adherence to medication. N Engl J Med. 2005;353:487–97.Google Scholar

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