Med-O-Meter

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MedHead Message:

I have always thought prescribing cholesterol medications in patients over 75 years old was fraught with caveats–do the risks of taking statin medications outweigh the benefits? After all, statins do cause some side effects, specifically with liver, muscle, and blood sugar levels. However, despite all this, multiple lines of evidence point toward statin use in folks over age 75 benefit, although not as much as those in younger age groups, from decreased overall death, including heart attacks and strokes. For every point in LDL (part of the cholesterol profile) that is decreased, the risks of a heart attack or stroke go down by about 20-24%. As physicians, we all need to be very careful about treating each patient as a person and not a group. This is very important.

References:

• 1. Daniele Pastori, Francesco Baratta, Arianna Di Rocco, Alessio Farcomeni, Maria Del Ben, Francesco Angelico, Francesco Violi, Pasquale Pignatelli, Gregory Y.H. Lip,
  Statin use and mortality in atrial fibrillation: A systematic review and meta-analysis of 100,287 patients,
  Pharmacological Research,Volume 165,2021,105418,ISSN 1043-6618, https://doi.org/10.1016/j.phrs.2021.105418.
• 2. Jane Armitage, Colin Baigent, Elizabeth Barnes, et. al. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials,The Lancet,Volume 393, Issue 10170, 2019, Pages 407-415, ISSN 0140-6736, https://doi.org/10.1016/S0140-6736(18)31942-1.
• 3. Anna Toso, Nuccia Morici, Mario Leoncini, Simona Villani, Luca A Ferri, Luigi Piatti, Daniele Grosseto, Irene Bossi, Paolo Sganzerla, Giovanni Tortorella, Michele Cacucci, Maurizio Ferrario, Stefano Tondi, Amelia Ravera, Francesco Bellandi, Claudio Cavallini, Roberto Antonicelli, Stefano De Servi, Stefano Savonitto, Association of statin pretreatment with presentation characteristics, infarct size and outcome in older patients with acute coronary syndrome: the Elderly ACS-2 trial, Age and Ageing, Volume 51, Issue 6, June 2022, afac121, https://doi.org/10.1093/ageing/afac121.