Managing Dyslipidemia in Older Adults1

Abstract

Elevated low density lipoprotein and total cholesterol levels are independent risk factors for CHD events in patients aged older than 65 years. Older adults have a higher risk of mortality attributable to hypercholesterolemia. Diet and lipid-lowering medications safely and effectively lower cholesterol levels in this age group. Exercise increases high-density lipoprotein cholesterol levels and decreases triglyceride levels. If accompanied by weight loss, exercise may reduce low-density lipoprotein and total cholesterol levels. Improving lipid levels in older adults with CHD decreases the risk of future coronary events by up to 45%, and significant effects on outcome measures may be observed within 2 years of the initiation of therapy.

A Path Model of Chronic Stress, the Metabolic Syndrome, and Coronary Heart Disease

“…Psychosocial correlates and predictors of CHD include greater chronic stress, anger, and hostility (54,55), higher levels of psychological distress (55,56), lower social supports (57), lower SES (58), and poorer health habits (59). Finally, the lack of positive experiences is associated with a greater waist-hip ratio (60) and worse glycemic control (61).…”

Dyslipidemia

“…If the LDL cholesterol clearly is elevated, statins or niacin should be considered first. • Women and the elderly should be treated along the same guidelines as their male and younger counterparts [17].…”

III Diretrizes Brasileiras Sobre Dislipidemias e Diretriz de Prevenção da Aterosclerose do Departamento de Aterosclerose da Sociedade Brasileira de Cardiologia

“…Os estudos de prevenção secundária com vastatinas mostram alta eficácia nessa faixa etária 193 . Em prevenção secundária, nos estudos 4S (incluídos 1.021 pacientes com idades entre 65 e 70 anos), CARE (incluídos 1.283 pacientes com mais de 65 anos) e LIPID (3.514 pacientes com idades entre 65 e 70 anos), foi demonstrada significativa redução de eventos clínicos e mortalidade com sinvastatina ou pravastatina.…”