0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Statins for Primary Prevention in Older Adults: Who Is High Risk, Who Is Old, and What Denotes Primary Prevention?

Susan J. Zieman, MD, PhD; and Pamela Ouyang, MBBS
[+] Article and Author Information

From Johns Hopkins University School of Medicine, Baltimore, Maryland, 21224, and Johns Hopkins Bayview Medical Center, Baltimore, Maryland, 21224.


Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-0521.

Requests for Single Reprints: Pamela Ouyang, MBBS, Division of Cardiology, A1-East, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224; e-mail, pouyang1@jhmi.edu.

Current Author Addresses: Dr. Zieman: Carnegie 568, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287.

Dr. Ouyang: Division of Cardiology, A1-East, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224.


Ann Intern Med. 2010;152(8):528-530. doi:10.7326/0003-4819-152-8-201004200-00011
Text Size: A A A

Whether to treat older adults with statin medications for primary prevention of cardiovascular events remains a clinical conundrum. A number of observations with regard to increasing age stoke this dilemma: The association between elevated cholesterol levels and cardiovascular risk diminishes (1), risk-prediction tools (such as the Framingham risk score) become less accurate (23), supporting clinical trial data become limited, and the decreasing life expectancy versus time to medication benefit constantly shifts. Additional downsides of statins for older adults include medication cost, polypharmacy, and possible side effects. Conversely, age alone makes older adults inherently high risk and statins reduce cardiovascular events and death and may have other beneficial effects. Clinical trial data support secondary prevention of cardiovascular events with statins for persons 80 years or younger, but data are scant thereafter. As the number of persons 65 years or older rapidly increases, and more so the number of persons 85 years or older, this clinical question needs to be addressed.

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)