Dyslipidaemia in elderly and stroke patients

Area of Science:

• Cardiology
• Geriatrics
• Pharmacology

Background:

• Cardiovascular disease (CVD) risk reduction is paramount in both elderly and younger populations.
• Lipid-lowering therapies play a critical role in managing atherogenic cholesterol particles.
• Decision-making for cholesterol management in older adults requires careful consideration of various factors.

Purpose of the Study:

• To summarize current knowledge on factors influencing lipid-lowering therapy decisions in the elderly.
• To review clinical trial evidence for risk-benefit assessment of hypolipidemic drugs in older individuals.
• To provide recommendations for optimal drug regimens in elderly stroke patients.

Main Methods:

• Collating and presenting robust clinical trial evidence on lipid-lowering drugs.
• Summarizing recommendations based on risk stratification, comorbidities, quality of life, and frailty.
• Reviewing evidence for primary and secondary prevention in elderly stroke patients.

Main Results:

• Factors influencing treatment decisions include atherosclerotic vs. non-atherosclerotic disease, comorbidity burden, quality of life, prognosis, lifestyle, and frailty.
• Evidence supports the use of various pharmacological interventions like statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, and Inclisiran.
• Optimal lipid-lowering therapy goals must be individualized based on stroke subtype and comorbidities.

Conclusions:

• Personalized risk-benefit assessment is essential for guiding lipid-lowering therapy in the elderly.
• A comprehensive approach considering clinical factors and robust evidence is necessary for effective cholesterol management.
• Tailored drug regimens are crucial for primary and secondary prevention of cardiovascular events in elderly stroke patients.