Statin Therapy in Very Old Patients: Lights and Shadows

Atherosclerotic cardiovascular diseases (ASCVD) are the leading cause of death worldwide. High levels of total cholesterol—and of low-density lipoprotein cholesterol in particular—are one of the main risk factors associated with ASCVD. Statins are first-line treatment for hypercholesterolemia and ha...

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Autores principales:	Lidia Cobos-Palacios, Jaime Sanz-Cánovas, Mónica Muñoz-Ubeda, María Dolores Lopez-Carmona, Luis Miguel Perez-Belmonte, Almudena Lopez-Sampalo, Ricardo Gomez-Huelgas, Maria Rosa Bernal-Lopez
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	statins elderly cardiovascular prevention frailty review Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/b1e0cda0b0c84768ae09a1bd2ba68562
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spelling	oai:doaj.org-article:b1e0cda0b0c84768ae09a1bd2ba685622021-12-01T13:33:21ZStatin Therapy in Very Old Patients: Lights and Shadows2297-055X10.3389/fcvm.2021.779044https://doaj.org/article/b1e0cda0b0c84768ae09a1bd2ba685622021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.779044/fullhttps://doaj.org/toc/2297-055XAtherosclerotic cardiovascular diseases (ASCVD) are the leading cause of death worldwide. High levels of total cholesterol—and of low-density lipoprotein cholesterol in particular—are one of the main risk factors associated with ASCVD. Statins are first-line treatment for hypercholesterolemia and have been proven to reduce major vascular events in adults with and without underlying ASCVD. Findings in the literature show that statins reduce coronary and cerebrovascular morbidity and mortality in middle-aged people, but their benefits in older adults are not as well-established, especially in primary prevention. Furthermore, many particularities must be considered regarding their use in old subjects, such as age-related changes in pharmacokinetics and pharmacodynamics, comorbidities, polypharmacy, and frailty, which decrease the safety and efficacy of statins in this population. Myopathy and a possible higher risk of falling along with cognitive decline are classic concerns for physicians when considering statin use in the very old. Additionally, some studies suggest that the relative risk for coronary events and cardiovascular mortality associated with high levels of cholesterol decreases after age 70, making the role of statins unclear. On the other hand, ASCVD are one of the most important causes of disability in old subjects, so cardiovascular prevention is of particular interest in this population in order to preserve functional status. This review aims to gather the current available evidence on the efficacy and safety of statin use in very old patients in both primary and secondary prevention.Lidia Cobos-PalaciosJaime Sanz-CánovasMónica Muñoz-UbedaMaría Dolores Lopez-CarmonaLuis Miguel Perez-BelmonteAlmudena Lopez-SampaloRicardo Gomez-HuelgasRicardo Gomez-HuelgasMaria Rosa Bernal-LopezMaria Rosa Bernal-LopezFrontiers Media S.A.articlestatinselderlycardiovascular preventionfrailtyreviewDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	statins elderly cardiovascular prevention frailty review Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	statins elderly cardiovascular prevention frailty review Diseases of the circulatory (Cardiovascular) system RC666-701 Lidia Cobos-Palacios Jaime Sanz-Cánovas Mónica Muñoz-Ubeda María Dolores Lopez-Carmona Luis Miguel Perez-Belmonte Almudena Lopez-Sampalo Ricardo Gomez-Huelgas Ricardo Gomez-Huelgas Maria Rosa Bernal-Lopez Maria Rosa Bernal-Lopez Statin Therapy in Very Old Patients: Lights and Shadows
description	Atherosclerotic cardiovascular diseases (ASCVD) are the leading cause of death worldwide. High levels of total cholesterol—and of low-density lipoprotein cholesterol in particular—are one of the main risk factors associated with ASCVD. Statins are first-line treatment for hypercholesterolemia and have been proven to reduce major vascular events in adults with and without underlying ASCVD. Findings in the literature show that statins reduce coronary and cerebrovascular morbidity and mortality in middle-aged people, but their benefits in older adults are not as well-established, especially in primary prevention. Furthermore, many particularities must be considered regarding their use in old subjects, such as age-related changes in pharmacokinetics and pharmacodynamics, comorbidities, polypharmacy, and frailty, which decrease the safety and efficacy of statins in this population. Myopathy and a possible higher risk of falling along with cognitive decline are classic concerns for physicians when considering statin use in the very old. Additionally, some studies suggest that the relative risk for coronary events and cardiovascular mortality associated with high levels of cholesterol decreases after age 70, making the role of statins unclear. On the other hand, ASCVD are one of the most important causes of disability in old subjects, so cardiovascular prevention is of particular interest in this population in order to preserve functional status. This review aims to gather the current available evidence on the efficacy and safety of statin use in very old patients in both primary and secondary prevention.
format	article
author	Lidia Cobos-Palacios Jaime Sanz-Cánovas Mónica Muñoz-Ubeda María Dolores Lopez-Carmona Luis Miguel Perez-Belmonte Almudena Lopez-Sampalo Ricardo Gomez-Huelgas Ricardo Gomez-Huelgas Maria Rosa Bernal-Lopez Maria Rosa Bernal-Lopez
author_facet	Lidia Cobos-Palacios Jaime Sanz-Cánovas Mónica Muñoz-Ubeda María Dolores Lopez-Carmona Luis Miguel Perez-Belmonte Almudena Lopez-Sampalo Ricardo Gomez-Huelgas Ricardo Gomez-Huelgas Maria Rosa Bernal-Lopez Maria Rosa Bernal-Lopez
author_sort	Lidia Cobos-Palacios
title	Statin Therapy in Very Old Patients: Lights and Shadows
title_short	Statin Therapy in Very Old Patients: Lights and Shadows
title_full	Statin Therapy in Very Old Patients: Lights and Shadows
title_fullStr	Statin Therapy in Very Old Patients: Lights and Shadows
title_full_unstemmed	Statin Therapy in Very Old Patients: Lights and Shadows
title_sort	statin therapy in very old patients: lights and shadows
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b1e0cda0b0c84768ae09a1bd2ba68562
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Statin Therapy in Very Old Patients: Lights and Shadows

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