ABSTRACT
The majority of coronary heart disease (CHD) mortality and morbidity occurs in
individuals over 65 years of age (1) and cardiovascular disease accounts for nearly 70% of
all deaths in this age group. Older patients have a particularly poor prognosis, and they are
more likely to suffer disability following a cardiovascular event. In addition, older persons
are more susceptible to stroke, which accounts for 1 in 15 deaths in the United States and
is the leading cause of serious, long-term disability. The majority of strokes, 80%, occur in
people over the age of 65 years. Finally, heart failure is of epidemic proportions in older
persons and new data suggest that lipid lowering may provide benefit in these patients (1).
Given increasing life expectancy and population aging, the number of individuals at risk of
cardiovascular events, including CHD, heart failure, and stroke, is expected to increase.
However, many older patients do not currently have their cardiovascular risk factors
assessed or suitably controlled. While national and international guidelines consider age to
be a risk factor for CHD (2), older persons are paradoxically less likely to receive
aggressive primary and secondary prevention (3,4). The aim of this chapter is to review
recent clinical trial data regarding lipid lowering in older individuals and to discuss current
gaps in the treatment of older persons.
