Statin therapy in elderly patients

Česká verzia

Authors: Jan Piťha ¹; Eva Topinková ²; Vladimír Bláha ³; Božena Jurašková ⁴; Ivo Bureš ⁵; Iva Holmerová ⁶; Michal Vrablík ⁷
Authors place of work: Interní klinika 2. LF UK a FN Motol, Praha ¹; Geriatrická klinika 1. LF UK a VFN v Praze ²; III. interní gerontometabolická klinika LF UK a FN Hradec Králové ³; Subkatedra geriatrie LF UK Hradec Králové ⁴; Geriatrické centrum Nemocnice Pardubice ⁵; Geriatrické centrum Praha ⁶; III. interní klinika 1. LF UK a VFN v Praze ⁷
Published in the journal: Vnitř Lék 2018; 64(11): 1021-1027
Category:

Summary

Cardiovascular events occur most frequently in patients at higher age groups. The elderly suffer not only more advanced and complex changes of cardiovascular system but, also, other chronic conditions. Moreover, compared to middle-age, different therapeutic response is often observed due to changes of pharmaco-kinetics and -dynamics; these patients use other medications, which may trigger drug interactions. The situation is further complicated by non-adherence related to frequent cognitive impairment. On one hand the elderly enjoy the greatest absolute benefit from adequate cardiovascular treatment while on the other they might be more susceptible to adverse reactions. In spite of the fact statins represent preventative medications, they must be indicated cautiously taken into consideration comorbidities, frailty and disability occurring in advanced age. Frail and disabled patients have greater risk of statin adverse effects, however, even these patients have lower mortality rates while being on statins. In seniors with life expectancy exceeding 5 years statins, when indicated, bring unambiguously proven benefit and should be considered high-priority medications.

Key words:

atherosclerosis – cardiovascular disease – dyslipidemia – elderly – frailty – management – statins

Zdroje

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