In a nutshell
This study investigated the effectiveness of cholesterol-lowering agents on cardiovascular outcomes in patients aged over 65.
They found that statins reduced the risk of cardiovascular events including heart attack and death.
Some background
Coronary artery disease (CAD) is caused by blockages in the arteries supplying blood to the heart. Blockages are caused by fatty deposits called plaques. Patients with CAD are prescribed drugs to reduce the levels of lipids (fat) in the blood. Thes drugs are called lipid-lowering agents. There are many of these drugs. However, not all are suitable for patients over 65. Statins are an example of a type of lipid-lowering agents used in older patients.
It is unclear if lipid-lowering agents are effective at preventing cardiovascular events. These include events such as heart attack, stroke, and death.
Methods & findings
This study reviewed 23 clinical trials. These included overall 60,194 patients over 65. The trials were separated into primary and secondary prevention trials. Primary prevention involves treating patients at risk for cardiovascular events. Secondary prevention involves reducing the risk of further cardiovascular events in patients who have already had one.
In primary prevention trials, statins reduced the risk of CAD by 21%. They also reduced the risk of heart attack by 55%. The risk of death due to CAD or other causes was not reduced. Stroke and heart failure risk were not improved by statins.
In secondary prevention trials, statins reduced the risk of death by 20%. They also reduced the risk of CAD and heart attack by 32%. Statins did not reduce the risk of heart failure or stroke. Intensive statin therapy was more effective at reducing CAD and heart failure risk.
The bottom line
The authors concluded that statins reduced the risk of cardiovascular events in patients aged 65 or older.
The fine print
There were only a few studies investigating other lipid-lowering drugs (niacin, fibrates). It is still unclear if they are useful in managing CAD in patients over 65.
What’s next?
If you have any concerns regarding CAD treatment, please consult with your doctor.
Published By :
The Journal of clinical endocrinology and metabolism
Date :
Mar 23, 2019
