The association between cholesterolemia and cardiovascular events decreases with aging, is neutral at the age of 75, and is reversed in octogenarians. To date, no randomized controlled trial has assessed the effects of statins in persons over 80 who, moreover, are a very heterogeneous population. In a patient aged 80 and older, the assessment of functional status, life expectancy, and preferences is essential when considering a preventive therapy (e.g. a statin). While scientific evidence is lacking, common sense suggests that, in patients aged 80 and older, a statin should be prescribed in secondary prevention patients with a life expectancy exceeding 1 year. It also suggests withholding or withdrawing a statin therapy in primary prevention patients (including patients with type 2 diabetes), regardless of their cholesterolemia, which should not be measured.
Key Words
Octogenarians, reverse epidemiology, heterogeneity, life expectancy, statin, appropriate prescribing
What is already known about the topic?
The benefit of statins in the prevention of cardiovascular accidents is no longer to be demonstrated in “classic” patients. Nevertheless, the question remains open in patients over 80 years.
What does this article bring up for us?
The article reports on an appropriate and reasoned statin prescription in patients aged 80 and older.