Cholesterol-lowering drugs in the elderly. When to initiate, maintain or discontinue therapy?

Emma E F Kleipool, Jannick A N Dorresteijn, Frank L J Visseren, Monika Hollander, Mike J L Peters, Majon Muller

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The risk of cardiovascular disease (CVD) can be reduced by lowering cholesterol, even at old age. However, there is a large spread in the level of risk of CVD in the elderly. Competing risks, time-to-benefit of the medication in relation to patient life expectancy and frailty must be taken into account when deciding whether or not to prescribe a cholesterol-lowering drug. When estimating cardiovascular risk in the elderly, one should use an age-adjusted individualized risk score that takes into account competing risks. In the case of energetic elderly people without vascular disease, one should start with cholesterol-lowering drugs only if they have a high risk of cardiovascular morbidity, for example, because of diabetes mellitus or very high blood pressure. Cholesterol-lowering drugs should not be prescribed to frail elderly people without vascular disease. A cholesterol-lowering drug should be started or continued in elderly patients with vascular disease. It should be stopped in case of unpleasant side effects or if life expectancy is no more than 1 to 2 years.

Translated title of the contributionCholesterol-lowering drugs in the elderly. When to initiate, maintain or discontinue therapy?
Original languageDutch
JournalNederlands Tijdschrift voor Geneeskunde
Volume162
Publication statusPublished - 5 Oct 2018

Cite this

Kleipool, E. E. F., Dorresteijn, J. A. N., Visseren, F. L. J., Hollander, M., Peters, M. J. L., & Muller, M. (2018). Cholesterolverlaging bij ouderen. Nederlands Tijdschrift voor Geneeskunde, 162.
Kleipool, Emma E F ; Dorresteijn, Jannick A N ; Visseren, Frank L J ; Hollander, Monika ; Peters, Mike J L ; Muller, Majon. / Cholesterolverlaging bij ouderen. In: Nederlands Tijdschrift voor Geneeskunde. 2018 ; Vol. 162.
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abstract = "The risk of cardiovascular disease (CVD) can be reduced by lowering cholesterol, even at old age. However, there is a large spread in the level of risk of CVD in the elderly. Competing risks, time-to-benefit of the medication in relation to patient life expectancy and frailty must be taken into account when deciding whether or not to prescribe a cholesterol-lowering drug. When estimating cardiovascular risk in the elderly, one should use an age-adjusted individualized risk score that takes into account competing risks. In the case of energetic elderly people without vascular disease, one should start with cholesterol-lowering drugs only if they have a high risk of cardiovascular morbidity, for example, because of diabetes mellitus or very high blood pressure. Cholesterol-lowering drugs should not be prescribed to frail elderly people without vascular disease. A cholesterol-lowering drug should be started or continued in elderly patients with vascular disease. It should be stopped in case of unpleasant side effects or if life expectancy is no more than 1 to 2 years.",
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Kleipool, EEF, Dorresteijn, JAN, Visseren, FLJ, Hollander, M, Peters, MJL & Muller, M 2018, 'Cholesterolverlaging bij ouderen' Nederlands Tijdschrift voor Geneeskunde, vol. 162.

Cholesterolverlaging bij ouderen. / Kleipool, Emma E F; Dorresteijn, Jannick A N; Visseren, Frank L J; Hollander, Monika; Peters, Mike J L; Muller, Majon.

In: Nederlands Tijdschrift voor Geneeskunde, Vol. 162, 05.10.2018.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Kleipool, Emma E F

AU - Dorresteijn, Jannick A N

AU - Visseren, Frank L J

AU - Hollander, Monika

AU - Peters, Mike J L

AU - Muller, Majon

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N2 - The risk of cardiovascular disease (CVD) can be reduced by lowering cholesterol, even at old age. However, there is a large spread in the level of risk of CVD in the elderly. Competing risks, time-to-benefit of the medication in relation to patient life expectancy and frailty must be taken into account when deciding whether or not to prescribe a cholesterol-lowering drug. When estimating cardiovascular risk in the elderly, one should use an age-adjusted individualized risk score that takes into account competing risks. In the case of energetic elderly people without vascular disease, one should start with cholesterol-lowering drugs only if they have a high risk of cardiovascular morbidity, for example, because of diabetes mellitus or very high blood pressure. Cholesterol-lowering drugs should not be prescribed to frail elderly people without vascular disease. A cholesterol-lowering drug should be started or continued in elderly patients with vascular disease. It should be stopped in case of unpleasant side effects or if life expectancy is no more than 1 to 2 years.

AB - The risk of cardiovascular disease (CVD) can be reduced by lowering cholesterol, even at old age. However, there is a large spread in the level of risk of CVD in the elderly. Competing risks, time-to-benefit of the medication in relation to patient life expectancy and frailty must be taken into account when deciding whether or not to prescribe a cholesterol-lowering drug. When estimating cardiovascular risk in the elderly, one should use an age-adjusted individualized risk score that takes into account competing risks. In the case of energetic elderly people without vascular disease, one should start with cholesterol-lowering drugs only if they have a high risk of cardiovascular morbidity, for example, because of diabetes mellitus or very high blood pressure. Cholesterol-lowering drugs should not be prescribed to frail elderly people without vascular disease. A cholesterol-lowering drug should be started or continued in elderly patients with vascular disease. It should be stopped in case of unpleasant side effects or if life expectancy is no more than 1 to 2 years.

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Kleipool EEF, Dorresteijn JAN, Visseren FLJ, Hollander M, Peters MJL, Muller M. Cholesterolverlaging bij ouderen. Nederlands Tijdschrift voor Geneeskunde. 2018 Oct 5;162.