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SAMIKSHA HEART AND DIABETIC CARE IN YELAHANKA NEW TOWN Dyslipidemia Average total serum cholesterol and low-density lipoprotein (LDL) cholesterol levels increase in men until approximately age 70 and then level off. In women, total serum cholesterol and LDL-cholesterol levels rise sharply after menopause and average 15–20 mg/dL higher than in men after age 60. Highdensity lipoprotein (HDL) cholesterol levels average about 10 mg/dL higher in women than in men throughout adult life. Although the strength of association of cholesterol levels with cardiovascular disease declines with age, in part due to the confounding effects of comorbid conditions and nutritional factors, low HDL-cholesterol levels and high total cholesterol to HDL-cholesterol ratios remain independent predictors of coronary events in older persons, including those over 80 years of age. In addition, observational studies and clinical trials indicate that statin therapy is associated with a reduction in cardiovascular events in moderate to high risk patients up to age 85.3 In the PROSPER trial, for example, which randomized 5804 patients 70-82 years of age to pravastatin or placebo, those receiving pravastatin experienced a 15% reduction in the primary outcome of coronary death, nonfatal myocardial infarction, or nonfatal or fatal stroke during a mean follow-up period of 3.2 years. Conversely, limited data are available on statin therapy in lower risk patients and in patients over 85 years of age. Treatment of these subgroups must therefore be individualized based on an overall assessment of potential benefits and risks.