TY - JOUR
T1 - [Cholesterol-lowering drugs in the elderly. When to initiate, maintain or discontinue therapy?]
AU - Kleipool, Emma E F
AU - Dorresteijn, Jannick A. N.
AU - Visseren, Frank L J
AU - Hollander, Monika
AU - Peters, Mike J L
AU - Muller, Majon
PY - 2018/10/5
Y1 - 2018/10/5
N2 - The risk of cardiovascular disease (CVD) can be reduced by lowering cholesterol, even at old age. However, there is a large spread in the level of risk of CVD in the elderly. Competing risks, time-to-benefit of the medication in relation to patient life expectancy and frailty must be taken into account when deciding whether or not to prescribe a cholesterol-lowering drug. When estimating cardiovascular risk in the elderly, one should use an age-adjusted individualized risk score that takes into account competing risks. In the case of energetic elderly people without vascular disease, one should start with cholesterol-lowering drugs only if they have a high risk of cardiovascular morbidity, for example, because of diabetes mellitus or very high blood pressure. Cholesterol-lowering drugs should not be prescribed to frail elderly people without vascular disease. A cholesterol-lowering drug should be started or continued in elderly patients with vascular disease. It should be stopped in case of unpleasant side effects or if life expectancy is no more than 1 to 2 years.
AB - The risk of cardiovascular disease (CVD) can be reduced by lowering cholesterol, even at old age. However, there is a large spread in the level of risk of CVD in the elderly. Competing risks, time-to-benefit of the medication in relation to patient life expectancy and frailty must be taken into account when deciding whether or not to prescribe a cholesterol-lowering drug. When estimating cardiovascular risk in the elderly, one should use an age-adjusted individualized risk score that takes into account competing risks. In the case of energetic elderly people without vascular disease, one should start with cholesterol-lowering drugs only if they have a high risk of cardiovascular morbidity, for example, because of diabetes mellitus or very high blood pressure. Cholesterol-lowering drugs should not be prescribed to frail elderly people without vascular disease. A cholesterol-lowering drug should be started or continued in elderly patients with vascular disease. It should be stopped in case of unpleasant side effects or if life expectancy is no more than 1 to 2 years.
UR - http://www.ncbi.nlm.nih.gov/pubmed/30358363
UR - http://www.mendeley.com/catalogue/cholesterollowering-drugs-elderly-initiate-maintain-discontinue-therapy
M3 - Article
C2 - 30358363
SN - 0028-2162
VL - 162
JO - Nederlands Tijdschrift voor Geneeskunde
JF - Nederlands Tijdschrift voor Geneeskunde
ER -