Statin Therapy Not Optimal for Patients 65+
Although what might seem to be counter-intuitive, a recent analysis supported NOT treating high cholesterol levels in patients aged 65 and older (especially 75 and older) for the primary prevention of coronary disease.
In a post-hoc analysis of the ALLHAT trial (Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack) the all-cause mortality was slightly higher in the group that was treated with statin therapy. Although the numbers did not reach statistical significance, the trend pointed to a higher event rate in the treated patients. These results were presented by Dr. Benjamin Han and his associates at the NYU School of Medicine.
It should be remembered that primary prevention is treatment for patients who have never been diagnosed with a disease process. In studies done on patients to look for the effects on secondary prevention (patients with proven atherosclerotic disease), there has been clear benefits shown in treating high cholesterol levels. Nonetheless these new results should give us pause in reaching for the cholesterol medication thinking that this is the panacea that will keep us free of cardiac disease no matter what the clinical situation dictates.