ABSTRACT
With increases in life expectancy and growth of the elderly population, including the very old, the topic of dyslipidemia in the elderly is becoming increasingly important. Although the relative risk associated with dyslipidemia may decrease with age, because the absolute risk increases, the risk of cardiovascular events attributable to elevated cholesterol is higher. A large pool of data has proven that statin treatment reduces atherogenic lipid levels and the risk of atherosclerotic cardiovascular disease as effectively in older high-risk individuals as in younger individuals. Indeed, clinical guideline statements support treatment of high-risk elderly patients with statins. Yet, despite these benefits, many high-risk older individuals are not receiving statins and other evidence-based therapies. Physicians must engage patients in discussions about the benefits and risks of therapy. Physicians must use the evidencebase, their knowledge of the patient, experience, and clinical judgment in deciding which patients to offer statins or other lipid-lowering treatments such as ezetimibe and PCSK9inhibitors. Of course, the decision will also need to incorporate patient preferences for another medication and overall healthcare goals, competing risks and life expectancy, and possible side effects and quality of life. Put simply, patients should not be denied statin therapy and other dyslipidemia interventions solely on the basis of age, but therapy should reflect a careful risk/benefit analysis.
