Abstract
The utility of lowering serum cholesterol in elderly patients has been questioned for a long time and is still a matter of debate (1). The main question concerns the role of hypercholesterolemia in elderly people, whether it represents at this age a risk factor for coronary heart disease (CHD) and myocardial infarction (MI) as in young people. A quite common opinion holds that the risk associated with total cholesterol “shows a definite waning effect with little impact after age 65” (2) and that “total cholesterol levels...are not considered important risk factors (in elderly patients) (3).
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References
Kaiser FE, Morley JE. Cholesterol can be lowered in older persons. Should we care? J Am Geriatric Soc 1990; 38:84–85.
Kannel WB, Gordon T. Cardiovascular risk factors in the aged: The Framingham Study. In: Haynes SG, Feinleib M. eds. Proceedings of the Second Conference on the Epidemiology of Aging. Bethesda, Maryland: National Institute of Health; 1977:65-89.
Moser M. The management of cardiovascular disease in the elderly. J Am Geriat Soc 1982; 30(suppl):SS20–S29.
Kannel WB, Castelli WP, Gordon T, McNamara PM. Serum cholesterol, lipoproteins, and the risk of coronary heart disease: the Framingham Study. Ann Intern Med 1971, 74:1–12.
Multiple Risk-Factor Intervention Trial: risk factor changes and mortality results. JAMA 1982, 248:1465-1477.
Dayton S, Pearce ML, Hasimoto S, Dixon WJ, Tomiyasu U. A controlled clinical trial of a diet high in un-saturated fat in preventing complications of atherosclerosis. Circulation 1969; 39 and 40(suppl II): 1–63.
Castelli WP, Garrison RI, Wilson PWF, et al. Incidence of coronary heart disease and lipoprotein cholesterol levels: the Framingham Study. JAMA 1986, 256:2835–2838.
Benfante R, Deed D: Is elevated serum cholesterol level a risk factor for coronary heart disease in the elderly? JAMA 1990, 263: 393–396.
Harris T, Cook EF, Kannel WB, Goldman L. Proportional hazard analysis of risk factors for coronary heart disease in individuals aged 65 or older. J Am Geriatr Soc 1988, 36: 1025–1028.
Rubin SM, Sidney S, Black DM, Browner WS, Hulley SB, Cummings SR. High blood cholesterol in elderly men and the excess risk for coronary heart disease. Ann Intern Med 1990; 113, 916–920.
Corti MC, Guralnik JM, Salive ME, Harris T, Field TS, Wallace RB, Berkman LF, Seeman TE, Glyn RJ, Hennekens CH, Havlik RJ. HDL Cholesterol Predicts Coronary Heart Disease in Older People. JAMA 1995; 274:539–544.
Forette B, Tortrat D, Wolmark Y. Cholesterol as risk factor for mortality in elderly women. Lancet 1989; 1:868–870.
Agner E, Hansen PF. Fasting serum cholesterol and triglycerides in a ten-year prospective study in old age. Acta Med Scand 1983; 214:33–61.
Rudman JD, Mattson DE, Nagraj HS, Caindec N, Rudman IW, Jackson DL. Antecedents of death in the men of a Veteran Administration nursing home. J Am Geriatr Soc 1987; 35:496–502.
Morley JE. Nutritional status of the elderly. Am J Med 1986; 81:679–695.
Isles CA, Hole DJ, Gillis CR, et al. Plasma cholesterol, coronary heart disease and cancer in the Renfrew and Paisley survey. Br Med J 1989; 298:920–924.
The Scandinavian Simvastatin Survival Study Group. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344:1383-1389.
Scandinavian Simvastatin Survival Study Group. Baseline serum cholesterol and treatment effect in the Scandinavian Simvastatin Survival Study (4S). Lancet 1995; 345:1274–1275.
Johannesson M, Jonsson B, Kjekshus J, Olsson AG, Pedersen TR, Wedel H, for the Scandinavian Simvastatin Survival Study Group. Cost effectiveness of simvastatin treatment to lower cholesterol levels in patients with coronary heart disease. N Engl J Med 1997; 336:332–336.
Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutheford JD, Cole TG, Brown L, Warnica W, Arnold MO, Wun CC, Davis BR, Braunwald E, for the Cholesterol and Recurrent Events Trial Investigators. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996; 335:1001–1009.
Byington RP, Jukema JW, Salonen JT, et al. Reduction in cardiovascular events during pravastatin therapy: pooled analysis of clinical events of the Pravastatin Atherosclerosis Intervention Program. Circulation 1995; 92:2419–2425.
Herd JA, Ballantyne CM, Farmer JA, Ferguson JJ, Gould KL, Jones PH, West MS, Gotto AM Jr. The effect of fluvastatin on coronary atherosclerosis: the lipoprotein and coronary atherosclerosis study (LCAS). 69th Scientific Session of the Americam Heart Association, New Orleans, November 11–13, 1996. Abstract book p. 1-597, n.3496.
Herd JA, West MS, Ballantyne CM, Farmer JA, Ferlic LL, Jonas PH, Gotto AM. Clinical cardiac and all fatal events in the lipoprotein and coronary atherosclerosis study (LCAS). 4th International Symposium on Multiple Risk Factors in Cardiovascular Disease, Washington, April 23–25, 1997. Abstract book, p.76.
Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, Macfarlane PW, Mckillop JH, Packard CJ, for the West of Scotland Coronary Prevention Study Group. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995; 333:1301–1307.
Vita JA, Treasure CB, Nabel EG, McLenachan JM, Fish RD, Yeung A, Vekshten VI, Selwyn AP, Ganz P. Coronary vasomotor response to acetylcholine relates to risks factors for coronary artery disease. Circulation 1990; 81:491–498.
Treasure CB, Klein JL, Weintraub WS, Talley JD, Stillabower ME, Kosinski AS, Zhang J, Boccuzzi SJ, Cedarholm JC, Alexander RW. Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease. N Engl J Med 1995; 332:481–487.
Haq IU, Jackson PR, Yeo WW, Ramsay LE. Sheffield risk and treatment table for cholesterol lowering for primary prevention of coronary heart disease. Lancet, 1995; 346:1467–1471.
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Capurso, A., Capurso, S.A. (1998). When and How to Treat Hypercholesterolemia in the Elderly?. In: Barbagallo, M., Licata, G., Sowers, J.R. (eds) Recent Advances in Geriatrics. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1483-5_24
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DOI: https://doi.org/10.1007/978-1-4899-1483-5_24
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