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Update on Hyperlipidemia in the Elderly: Is This a Risk Factor for Heart Disease?
William B. Kannel1, Peter W.F. Wilson
1Department of Medicine, Section of Preventive Medicine and Epidemiology, Evans Memorial Research Foundation, Boston University School of Medicine/Framingham Heart Study, Boston, MA.
The American Journal of Geriatric Cardiology
|October 1, 1996
Summary
Lipid screening in the elderly shows conflicting results for total cholesterol but highlights high-density lipoprotein-cholesterol (HDL-C) as a key marker for coronary heart disease (CHD). Further trials are needed to assess lipid-lowering treatments in older adults.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Lipidology
Background:
- Conflicting evidence exists regarding the utility of lipid screening in the elderly for predicting coronary heart disease (CHD).
- While total cholesterol lacks consistent association with CHD in older adults, high-density lipoprotein-cholesterol (HDL-C) and the total/HDL-C ratio show promise as effective markers.
- The attributable risk for CHD from lipid abnormalities may be higher in the elderly due to a greater event burden, despite a declining relative risk.
Purpose of the Study:
- To review the current evidence on lipid screening in the elderly and its association with coronary heart disease (CHD).
- To evaluate the role of high-density lipoprotein-cholesterol (HDL-C) and total/HDL-C ratio as CHD risk markers in older populations.
- To advocate for targeted clinical trials of lipid-altering therapies in individuals over 65 years of age.
Main Methods:
- Systematic review of existing literature on lipid screening and CHD in the elderly.
- Analysis of studies examining the association between lipid profiles (total cholesterol, HDL-C, total/HDL-C ratio) and CHD incidence in older adults.
- Evaluation of data from clinical trials on lipid-lowering agents in middle-aged populations.
Main Results:
- Many studies report no significant association between total cholesterol levels and CHD development in the elderly.
- Recent investigations indicate that HDL-C levels and the total/HDL-C ratio are effective predictors of CHD in older populations.
- Despite a decrease in relative risk, the attributable risk for CHD from adverse lipid profiles is substantial in the elderly due to higher event rates.
Conclusions:
- High-density lipoprotein-cholesterol (HDL-C) and the total/HDL-C ratio are valuable lipid markers for assessing coronary heart disease (CHD) risk in elderly individuals.
- Further research, including dedicated clinical trials, is warranted to determine the efficacy and safety of lipid-lowering interventions in adults aged 65 and older.
- Targeted lipid management strategies may reduce morbidity and mortality associated with CHD in the aging population.