Current Drug Treatment of Hyperlipidemia in Older Adults

Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death, especially in older adults. Managing modifiable risk factors (e.g., hyperlipidemia, hypertension) remains the primary approach to prevent ASCVD events and ASCVD-related mortality. Statins are generally considered one of the most effective approaches to reduce ASCVD risk, especially for secondary prevention, yet remain underutilized in older adults. The evidence to support statin therapy in older adults is less robust than in their younger counterparts, especially in individuals aged 75 years and older. Recent lipid guidelines have raised this concern, yet statin therapy is recommended in 'at risk' older adults. Determining which older adults should receive statin therapy for primary prevention of ASCVD is challenging, as the currently available risk estimation tools are of limited use in those aged over 75 years. Furthermore, non-statin therapies have been de-emphasized in recent clinical practice guidelines and remain understudied in the older adult population. This is unfortunate given that older adults are less likely to tolerate moderate- to high-intensity statins. Non-statin therapies could be viable options in this population if more was understood about their ability to lower ASCVD risk and safety profiles. Nevertheless, lipid-lowering agents remain an integral component of the overall strategy to reduce atherogenic burden in older adults. Future research in this area should aim to enroll more older adults in clinical trials, determine the utility of ASCVD risk estimation for primary prevention, and investigate the role of non-statin therapies in this population.

Antihyperlipidemic and hepatoprotective properties of alkali- and enzyme-extractable polysaccharides by Dictyophora indusiata

“…It has been reported that nearly 23.6 million people will die from cardiovascular diseases originating from hyperlipidemia by 2030 3 . Furthermore, the incidence of hyperlipidemia is increasing gradually, and may aggravate with aged tendency of population 4 . Hence, the prevention and management of hyperlipidemia is important.…”

Primary prevention of cardiovascular disease in older adults in China

“…Hence, statin therapy for older adults has been recommended to be initiated at a low dose and gradually titrated according to the response of patients, especially in Chinese who are 80 years old and above[ 2 , 3 , 6 , 27 , 34 , 35 ]. Non-statin therapies can be considered for older adults who cannot tolerate statin or cannot attain target LDL-C level after taken maximum tolerated statin therapy[ 44 ].…”

Hypolipidemic activity of P-methoxycinnamic diester (PCO-C) isolated from Copernicia prunífera against Triton WR-1339 and hyperlipidemic diet in mice

“…The incidence of hyperlipidemia is gradually increasing, and may worsen with an aging population. Therefore, the prevention and management of hyperlipidemia is important (Dixon et al, 2015).…”