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Is hypercholesterolemia a risk factor and should it be treated in the elderly?
1Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
American Journal of Health Promotion : AJHP
|November 7, 2000
Summary
Cholesterol treatment in elderly individuals effectively reduces coronary heart disease risk for secondary prevention. Further research is needed for primary prevention and in those over 70.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Pharmacology
Background:
- The National Cholesterol Education Program (1993) recommends cholesterol screening for elderly patients, including those with and without coronary heart disease.
- Evidence-based guidelines necessitate a review of clinical trial data on cholesterol management in older adults.
Purpose of the Study:
- To review clinical trial evidence on the efficacy of cholesterol treatment in the elderly population.
- To summarize findings related to cardiovascular disease endpoints in elderly individuals undergoing lipid-altering therapies.
Main Methods:
- A comprehensive MEDLINE search (1966–2000) and review of bibliographies identified relevant studies.
- Inclusion criteria focused on randomized, controlled clinical trials assessing lipid interventions and cardiovascular outcomes in elderly participants or subgroups.
- Five clinical trials meeting all selection criteria were analyzed, providing unique data.
Main Results:
- Analysis of five key clinical trials with elderly participants revealed significant findings.
- Data synthesized from these trials indicate a reduction in major coronary heart disease risk by 25%–30% over 5 years in treated elderly subjects.
- Results are presented in both textual summaries and a comparative table.
Conclusions:
- Clinical trial evidence supports the use of lipid-lowering treatment for secondary prevention of coronary heart disease in the elderly.
- Significant risk reduction for major coronary heart disease events was observed in elderly individuals treated for hyperlipidemia.
- Further investigation is required to establish optimal cholesterol treatment strategies for primary prevention, specific gender benefits, and individuals over 70 years of age.