Lipid disorders: applying new guidelines to your older patients

The National Cholesterol Education Program Expert Panel has revised its recommendations for managing hypercholesterolemia in adults, including those at midlife and older. In utilizing these guidelines, it is important for the physician to develop an individualized approach to the older patient with hypercholesterolemia. Patient characteristics to consider include lifespan limitations, presence and severity of concomitant disease, mental status and cognitive ability, and the patient's expectations from medical care. Dietary intervention is the first step, with the major focus on restricting saturated fat and cholesterol. Lipid-lowering agents may be warranted in some patients to achieve target LDL levels. Minimize the risk of side effects by careful monitoring and using medications cautiously.