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Hypercholesterolemia in Elderly Persons: Resolving the Treatment Dilemma

Margo A. Denke, MD; and Scott M. Grundy, MD, PhD
[+] Article and Author Information

Grant Support: In part by the Veterans Affairs grant HL-29252 from the National Institutes of Health, the Southwestern Medical Foundation, and the Moss Heart Foundation, Dallas, Texas.

Requests for Reprints: Scott M. Grundy, MD, PhD, Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Room Y3.206, Dallas, TX 75235-9052.

Current Author Addresses: Drs. Denke and Grundy: Center for Human Nutrition, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235-9052.


© 1990 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1990;112(10):780-792. doi:10.7326/0003-4819-112-10-780
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Of all age groups, men and women over 60 years of age have the highest prevalence of elevated serum cholesterol levels. Now that detection and treatment of high serum cholesterol levels are increasing, we need a rational approach to managing elevated cholesterol levels in elderly patients. Recent data indicate that high total cholesterol and low-density lipoprotein levels predict risk for coronary heart disease in patients over 60 years of age. However, selecting appropriate candidates for cholesterol-lowering therapy requires clinical judgment of the relative risks and benefits of each therapy and consideration of each patient's overall health status as well as of competing risks. Active medical management of high cholesterol levels, therefore, should be restricted to a limited fraction of elderly patients who are most likely to benefit from long-term therapy. The first line of treatment is diet modification; however, drug therapy for appropriate patients is not contraindicated because of age alone.

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