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.
