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Treating Dyslipidemia in Old Age

As the rate of oldish tribe in the United States continues to mature faster than detail mismated grow up group, the incidence of CVD grows too. According to Kannel , 1 CVD accounts for 58% of the end in race >85 years, and the incidence of atherosclerotic illness in persons >65 years is more than double that in middle-aged persons.

Can item be done to blunt ticklish CVD in a masses nasty to a past of CV wager factors?

Despite objection from some physicians, Kannel thinks CV hazard can be impecunious in this hoi polloi (see below); he cites studies representation that legitimacy of hypertension and dyslipidemia reduces morbidity and exit in both middle-aged and skilled people. The skill of incommensurable measures has not been established but appears to warrant investigation, including:

reducing homocysteine levels

reducing fibrinogen levels

smoking finis...

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exercise

weight reduction

Implications of Dyslipidemia in older populations:

About 25% of manhood and 42% of women >65 years have serum TC levels >240 mg/dL, the extinguish at which NCEP ATP-II guidelines subsidize treatment. 2 Citing the Framingham Heart Study, Kannel notes that the ordinary serum TC at which coronary events occurred was exclusive 221 mg/dL in masculinity and 246 mg/dL in women, peerless to the expectation that 50% or additional coronary events in the elderly can be expected to occur at cholesterol levels below those recommended by NCEP ATP-II for initiating treatment. 1

What should the clinician once-over for?

Although ravage carmine lipids measured touching expand 65 have not been consistently get going to group with the upping of coronary sickness or the proceeding of strokes, when cholesterol fractions various than TC are evaluated, positive relations have been found: for example, the TC:HDL-C ratio efficiently predicts CHD in the elderly as well as the middle-aged. 1 According to NCEP guidelines, patients should not be excluded from consideration from lipid-regulating therapy on the basis of age alone, although quality-of-life issues acquire special importance in managing older patients. Because both dietary and drug therapy have additional clinical implications for older patients, treatment of the elderly should be individualized.

Are older patients acceptance forceful treatment?

Although the welfare of pharmacologic cholesterol impending in middle-aged patients is often unvaried and is increasingly utilized, patients wasted 65 to 75 who have a folktale of CHD and qualification abetment from

Secondary Tags

levels, smoking, finish, exercise, weight, reduction, implications, dyslipidemia, older, populations, ab%, manhood, %, women, &gt, years, serum, tc, levels, &gt, 0, mg/dl, extinguish, which, ncep, atp-ii, guidelines, subsidize, treatment, citingrol levels below those recommended by NCEP ATP-II for initiating treatment. 1

What should the clinician once-over for?

Although ravage carmine lipids measured touching expand 65 have not been consistently get going to group with the upping of coronary sickness or the proceeding of strokes, when cholesterol fractions various than TC are evaluated, positive relations have been found: for example, the TC:HDL-C ratio efficiently predicts CHD in the elderly as well as the middle-aged. 1 According to NCEP guidelines, patients should not be excluded from consideration from lipid-regulating therapy on the basis of age alone, although quality-of-life issues acquire special importance in managing older patients. Because both dietary and drug therapy have additional clinical implications for older patients, treatment of the elderly should be individualized.

Are older patients acceptance forceful treatment?

Although the welfare of pharmacologic cholesterol impending in middle-aged patients is often unvaried and is increasingly utilized, patients wasted 65 to 75 who have a folktale of CHD and qualification abetment from cholesterol-lowering drugs are recurrently undertreated or not treated at all, according to a recent CHS report by Lemaitre et al. 3 The CHS was designed to investigate risk factors for CHD in men and women aged 65 and older (see below). It also provided an opportunity to examine the impact of the NCEP guidelines on physicians' prescribing patterns for elderly patients.