Managing dyslipidemia in older adults

OBJECTIVES: To summarize and critically review clinical trial data regardin g dyslipidemia as a risk factor for coronary heart disease (CHD) and the ef ficacy and safety of lipid-lowering interventions in older adults. Based on these data, clinical recommendations for diagnosing and managing dyslipide mia in older adults are provided. METHODS: Peer-reviewed journal articles were identified by a MEDLINE search and a review of journal article references. Studies that were performed ex clusively in subjects older than 65 years or that included a large subgroup of older adults were included. CONCLUSIONS: Elevated low density lipoprotein and total cholesterol levels are independent risk factors for CHD events in patients aged older than 65 years. Older adults have a higher risk of mortality attributable to hyperch olesterolemia. Diet and lipid-lowering medications safely and, effectively lower cholesterol levels in this age group. Exercise increases high-density lipoprotein cholesterol levels and decreases triglyceride levels. If accom panied by weight loss, exercise may reduce low-density lipoprotein and tota l cholesterol levels. Improving lipid levels in older adults with CHD decre ases the risk of future coronary events by up to 45%, and significant effec ts on outcome measures may be observed within 2 years of the initiation of therapy.