Yale: Statin Cholesterol Drugs Risks
Outweigh CAD Benefits in the Elderly...

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1: Am J Geriatr Cardiol. 2003 Nov-Dec;12(6):357-60. Related Articles, Links

Are statins indicated for the primary prevention of CAD in octogenarians? Antagonist viewpoint.
Foody JM, Krumholz HM.

The Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT; and The Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT 06520 harlan.krumholz@yale.edu

Statin therapy (3-hydroxy-3methylglutaryl coenzyme A reductase inhibitor) is beneficial for primary prevention of cardiovascular events in patients younger than age 65 years with hyperlipidemia, yet there is uncertainty about using these agents for primary prevention in octogenarians. We present the case that can be made for not treating octogenarians with statins for the primary prevention of cardiovascular disease. This case is built on three points:

1) cholesterol levels are not associated with cardiovascular disease events in octogenarians without overt coronary artery disease;

2) no randomized, controlled trials have assessed the role of statins in reducing events in octogenarians without coronary artery disease; and

3) statins may increase risks of myositis, rhabdomyolysis, and cancer in the elderly. In view of gaps in the current evidence and the resulting clinical uncertainty, it is unclear whether the balance of risk and benefit favors treatment for the primary prevention of coronary artery disease in octogenarians. The use of statins in this age group should be based on patient preference.

PMID: 14610384 [PubMed - in process]



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