Hyperlipidemia in the elderly

The elderly subject: Cardiovascular prevention trials have clearly establis hed the beneficial effect of lipid-lowering drugs, basically statins, for a dults, and in particular for adult mates. There has not however been any st udy specifically analyzing prevention in the elderly In addition, the relat ionships between high cholesterol level and cardiovascular risk in the elde rly subject are complex and require specific adaptation with markers of poo r hearth status. Preventive measures: Even though the relationship between elevated total ch olesterol or LDL-cholesterol and cardiovascular risk is difficult to demons trate in the elderly, analyses of subpopulations are beginning to show evid ence that a lipid-lowering treatment can have a beneficial preventive effec t in the elderly. Other research avenues also point to perspectives for str oke prevention or reduced risk of dementia in patients treated with statins . Recommendations: Until the results of ongoing clinical trials become availa ble, recommendations far therapeutic strategies in the elderly are basicall y founded on clinical experience in light of current evidence. It is reason able to recommend a lipid-lowering regimen for secondary prevention and to continue treatment beyond 70 years for primary prevention if the patient's overall cardiovascular risk warrants prevention. But on the basis of curren t evidence, there is no rationale for recommending a large screening of hyp ercholesterolemia in primary prevention in subjects over 70 years of age. L ikewise, taking into account associated disease slates and the increased ri sk of drug interactions, primary prevention regimens cannot be recommended except for elderly patients with a high overall cardiovascular risk.