Dyslipidaemia in the elderly: to treat or not to treat?

ABSTRACT

Introduction: The elderly population (i.e. aged ≥ 65 years) is increasing worldwide. Ageing is associated with a higher incidence and prevalence of cardiovascular disease (CVD).

Areas covered: The prevalence of CVD risk factors including type 2 diabetes mellitus, hypertension and dyslipidaemia also increases with advancing age, contributing to the higher absolute CVD risk observed in the elderly. The present narrative review comments on the associations of dyslipidaemia with CVD as well as the effects of lifestyle measures and lipid-lowering drugs on lipids and CVD risk with a special focus on the elderly population. Individual treatment goals and therapeutic options according to current guidelines are also reviewed. Finally, we discuss special characteristics of the elderly that may influence the efficacy and safety of drug therapy and should be considered before selection of hypolipidaemic pharmacotherapy.

Expert commentary: There may be a greater CVD benefit in older patients following drug therapy compared with younger ones. Treatment goals and therapeutic options should be individualized according to current guidelines. Specific characteristics that may influence the efficacy and safety of drug therapy in the elderly should be considered in relation to dyslipidaemia treatment.

KEYWORDS:

• Dyslipidaemia
• elderly
• statins
• cardiovascular risk
• guidelines
• lipid-lowering drugs

Declaration of interest

N Katsiki has given talks, attended conferences and participated in trials sponsored by Amgen, Angelini, Astra Zeneca, Boehringer Ingelheim, MSD, Novartis, NovoNordisk, Sanofi and WinMedica. G Kolovou has given talks, attended conferences and participated in trials sponsored by Amgen, Angelini, MSD, Lilly, Vianex and Sanofi-Aventis and have also accepted travel support to conferences from Amgen, Sanofi and MSD. P Perez-Martinez has given talks and participated in trials sponsored by Bristol-Myers Squibb/Astra Zeneca, Merck Sharp & Dohme, Boehringer Ingelheim, Eli Lilly, Novartis, Ferrer, Esteve, GlaxoSmithKline, Pfizer, Janssen-Cilag, Amgen and Sanofi. DP Mikhaildis has given talks and attended conferences sponsored by MSD, AstraZeneca and Libytec. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.