People over 75 should consider taking statins

According to new studies on statins and other cholesterol-lowering therapies show they help lower the risk of heart attack, stroke, and other vascular events.

But many of those studies have enrolled few older adults, leaving questions about the potential benefits and risks of prescribing cholesterol-lowering therapies to patients over the age of 75.

A new review of research published in The LancetTrusted Source this week strives to answer some of those questions.

The authors of the review found evidence that older adults experience similar benefits as younger adults from cholesterol-lowering therapies.

“A stroke or a massive heart attack can be devastating at any age, especially when it can be prevented by a safe, well-researched medication,” Dr. Eugenia Gianos, the director of Women’s Heart Health at Lenox Hill Hospital in New York City, told Healthline.

“This study emphasizes the urgent need to enroll elderly patients into research trials so that we have the evidence for what works best,” she said.

To evaluate the available evidence on cholesterol-lowering therapies in older adults, the authors of the new review combined and analyzed data from six previously published articles.

Those articles reported findings from 29 clinical trials on cholesterol-lowering medications, including statins, PCSK9 inhibitors, and ezetimibe.

A total of 244,090 patients participated in the trials, 21,492 of whom were 75 years of age or older.

The authors of the review found that treatments to lower cholesterol helped reduce the risk of major vascular events in both older and younger patients.

Among older patients, the risk of major vascular events dropped by 25 percent for every 1 mmol/L (millimoles per liter) reduction in LDL cholesterol.

Older patients who received cholesterol-lowering therapies were less likely to experience heart attack, stroke, or death from loss of heart function. They were also less likely to undergo coronary revascularization, a procedure used to widen blocked or narrowed arteries.

When the authors of the review examined the safety data on cholesterol-lowering therapies, they found no offsetting safety concerns in older adults.

They found no evidence that cholesterol-lowering therapies raise the risk of cancer, hemorrhagic stroke, new-onset diabetes, or neurocognitive adverse effects in older patients.

However, little safety data was available for most of the trials they assessed.

More research is needed to learn about the risks of different cholesterol-lowering medications in older adults, some of whom might be better candidates than others for certain treatment approaches.

“Elderly patients are more prone to side effects of numerous medications. Therefore, we have to study the short- and long-term risk of specific classes of cholesterol medications in this population,” said Dr. Benjamin J. Hirsh, director of preventive cardiology at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, New York.

“The benefit versus risk balance is essential. To better understand this balance, we need to more clearly understand the risks,” he added.

To learn if cholesterol-lowering medications may be a good choice for them, patients should speak with their healthcare providers.

“The decision to add cholesterol medications should be made on the basis of a patient’s cardiovascular risk profile, personal preference, and an informed discussion between the patient and provider,” said Hirsh.

Patients who are at high risk of heart disease and stroke should schedule regular visits with a cardiovascular specialist, advises Dr. Ian J. Neeland, a preventive cardiologist and director of cardiovascular prevention and co-director of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease for University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio.

Eating a well-balanced diet, getting regular exercise, and practicing other healthful habits is also essential for managing cholesterol levels and lowering the risk of heart attack, stroke, and other vascular events.

“It is important to know that older adults are at the highest risk for cardiovascular disease events such as heart attack and stroke. They likely benefit the most from aggressive preventive strategies and therapies,” Neeland said.

“Just because they are ‘older’ doesn’t mean they should be lax in lifestyle and medical care. The goal is to help older adults keep living meaningful and healthful lives for years to come,” he added.

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