Lipid-Targeted Atherosclerotic Risk Reduction in Older Adults: A Review

Aggressive lipid-lowering lifestyle modifications and pharmacologic therapies are the cornerstones of the primary and secondary prevention of atherosclerotic cardiovascular disease events. While statins are highly effective, inexpensive, and generally well-tolerated medications, many clinicians and...

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Bibliographic Details
Published in:Geriatrics (Basel) 2022-03, Vol.7 (2), p.38
Main Authors: Hassen, Lauren J, Scarfone, Steven R, Milks, Michael Wesley
Format: Article
Language:English
Subjects:
Angina pectoris
Atherosclerosis
Cardiovascular disease
Cholesterol
Clinical practice guidelines
Dementia
Diabetes
Diet
Disease prevention
Drug dosages
Hyperlipidemia
Lifestyles
lipid-lowering therapy
Lipids
low density lipoprotein
Mortality
Muscle pain
Nutrition research
Older people
Population
Review
statin
Statins
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Summary:Aggressive lipid-lowering lifestyle modifications and pharmacologic therapies are the cornerstones of the primary and secondary prevention of atherosclerotic cardiovascular disease events. While statins are highly effective, inexpensive, and generally well-tolerated medications, many clinicians and patients express uncertainty regarding the necessity of statin treatment in older adults. Citing concerns such as polypharmacy, muscle symptoms, and even potential cognitive changes with statins, many patients and health care providers elect to de-intensify or discontinue statin therapy during the process of aging. A lack of clear representation of older individuals in many clinical trials and practice guidelines may contribute to the ambiguity. However, the recently prevailing data and practice patterns supporting the benefits, safety, and tolerability of a variety of lipid-lowering therapeutics in older adults are discussed here, with particular mention of a potential protective effect from incident dementia among a statin-treated geriatric population and an admonishment of the historical concept of "too-low" low-density lipoprotein cholesterol (LDL-C) levels.
ISSN:2308-3417
2308-3417
DOI:10.3390/geriatrics7020038