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Attainment of multifactorial treatment targets among the elderly in a lipid clinic

Fotios Barkas1, Evangelos Liberopoulos1, Eleftherios Klouras1

  • 1Department of Internal Medicine, University of Ioannina Medical School, Ioannina, Greece.

Journal of Geriatric Cardiology : JGC
|June 20, 2015
PubMed

Insights

Many elderly patients in specialist care did not meet lipid-lowering, blood pressure, or blood sugar targets. Combination therapy and less strict goals may improve treatment outcomes for older adults.

Area of Science:

  • Cardiology
  • Endocrinology
  • Geriatrics

Background:

  • Elderly patients often have multiple chronic conditions requiring complex treatment regimens.
  • Optimizing lipid-lowering, antihypertensive, and antidiabetic therapies is crucial for cardiovascular risk reduction in older adults.

Purpose of the Study:

  • To evaluate the achievement of treatment targets for low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and glycated hemoglobin (HbA1c) in elderly patients.
  • To assess treatment outcomes in a specialist setting at a University Hospital in Greece.

Main Methods:

  • Retrospective study of 465 patients aged 65 years or older with a follow-up of at least 3 years.
  • Assessment of LDL-C, BP, and HbA1c goal attainment based on established European guidelines (ESC/EAS, ESH/ESC, EASD).

Main Results:

  • LDL-C targets were met by 27-62% of patients based on risk stratification. Statin + ezetimibe combination therapy showed higher LDL-C goal achievement than statin monotherapy (48% vs. 33%).
  • BP targets were achieved by a majority of diabetic (71% < 140/85 mmHg) and non-diabetic (78% < 140/90 mmHg) patients. A significant proportion of diabetic patients (88%) achieved HbA1c < 8%, while 47% achieved < 7%.
  • Only about one-third of non-diabetic and one-tenth of diabetic patients achieved all three treatment targets simultaneously.

Conclusions:

  • A substantial proportion of elderly patients in a specialist hospital setting have suboptimal LDL-C, BP, and HbA1c levels.
  • Combination drug therapy may enhance multifactorial treatment target attainment in the elderly.
  • Less stringent treatment targets might be more achievable for this patient population.
Abstract

Keywords:
Blood pressureGlycated hemoglobinGoal achievementLow-density lipoprotein cholesterol

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