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Hyperlipidemias in elderly patients: results from the Berlin Aging Study II (BASEII), a cross-sectional study
Adrian Rosada1, Ursula Kassner2, Felix Weidemann3
1Department of Geriatrics, Charité Universitätsmedizin Berlin, Berlin, Germany. adrian.rosada@charite.de.
Insights
Hyperlipidemias are common, particularly in older adults, yet often undiagnosed and undertreated, increasing cardiovascular disease risk. Consistent screening and treatment are crucial for managing this prevalent condition.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Lipidology
Background:
- Hyperlipidemias are a significant risk factor for atherosclerosis and cardiovascular diseases.
- These lipid disorders often lack symptoms, leading to delayed diagnosis until a major cardiovascular event.
- Effective treatments exist for LDL-hypercholesteremia, but optimal management in elderly patients requires further investigation.
Purpose of the Study:
- To determine the prevalence of hyperlipidemia in elderly and young community-dwelling individuals.
- To assess the extent of hyperlipidemia diagnosis and treatment initiation in these groups.
- To evaluate treatment target achievement according to established guidelines.
Main Methods:
- Cross-sectional analysis of 2151 participants from the Berlin Aging Study II (BASE-II).
- Inclusion of 1657 elderly (mean age 69) and 494 young (mean age 29) subjects.
- Medical history assessment by physicians and laboratory lipid-profile tests.
Main Results:
- 39% of participants were unaware of their lipid disorder.
- Hyperlipidemia prevalence was higher in the elderly (76%) versus young (41%) groups.
- Hypercholesterolemia (64%) was most common; only 17% received lipid-lowering medication, with 16.5% meeting treatment targets.
Conclusions:
- Hyperlipidemias are underdiagnosed and undertreated, especially in the elderly.
- Increasing prevalence with age highlights the need for proactive management.
- Consistent screening and treatment are recommended due to the modifiable risk factor status for cardiovascular disease.
Background:
Hyperlipidemias are common and the last decades have seen substantially growing evidence of their causative role in the development of atherosclerosis and subsequent cardiovascular diseases. Since hyperlipidemias usually do not cause direct clinical symptoms, they often remain undiagnosed until a serious cardiovascular event occurs. Especially for LDL-hypercholesteremia, there are well-established treatment options available to prevent the occurrence of atherosclerosis. However, there is a lack of knowledge regarding the proper treatment of elderly patients. The goal of this study was to assess the prevalence of hyperlipidemia in a group of young and a group of elderly community-dwelling participants and to determine to what extent treatment of hyperlipidemia should be initiated or required.
Methods:
Crossectional data from a total of 2151 subjects (1657 in the elderly group, mean age 69, and 494 in the young group (control group), mean age 29) of the Berlin Aging Study II (BASE-II) were available. Medical history was assessed and recorded by trained physicians and prevalence of lipid disorders was determined with laboratory tests, including a lipid-profile.
Results:
A large proportion of subjects (39%) were unaware of an existing lipid disorder. The prevalence of hyperlipidemia was more frequent in the elderly group (76%) compared to the young group (41%). Hypercholesterolemia was the most common diagnosed disorder (64%), followed by hyperlipoproteinemia(a) (18%), hypertriglyceridemia (7%) and combined hyperlipoproteinaemia (5%). Only a minority of this cohort was treated with lipid-lowering medication (17%) and of those treatment targets according to ESC guidelines were reached only in 16.5 %.
Conclusions:
Hyperlipidemias appear underdiagnosed and undertreated. As the prevalence of these disorders increases with age and with regard to their role as a major modifiable risk factor for cardiovascular disease it seems to be advisable to aim for more consistent and sustainable screening and treatment of these common disorders.
Trial Registration:
BASE-II registered with the clinical trial registry Deutsches Register Klinischer Studien (DRKS00009277).
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