Management Strategies of Dyslipidemia in the Elderly: 2005

Tarek Helmy, MD; Amar D. Patel, MD; Fadi Alameddine, MD; Nanette K. Wenger, MD, FACC, FAHA

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Conclusions and Future Directions

Reducing LDL-C has been shown to decrease cardiovascular events to 80 years of age, but studies are needed to explore the efficacy of lipid-lowering therapy in individuals older than 80 years. The magnitude of delay in progression of atherosclerotic disease in response to screening-guided therapy has not been well delineated. The cost-effectiveness of lipid screening in the elderly population, as well as the subgroups that would benefit most from such screening, need to be further studied. Based on ongoing clinical trial data, the guidelines may be modified to recommend that an LDL-C ≤ 70 mg/dL is the target level for special high-risk populations. In the PROVE-IT study, a subgroup analysis showed less benefit in patients over the age of 65 compared with patients less than 65 years of age. The TNT trial excluded patients over the age of 75. Hence, the applicability of these data to the elderly population needs to be better defined. Optimal implementation of the current guidelines and the use of available agents will ultimately depend on expanding the knowledge base of healthcare providers, and may require far-reaching educational programs that change the way that risk-factor management is viewed by caregivers and patients alike.

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