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 [email protected]
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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