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[老年人血脂异常]

[Dyslipidemia in the elderly].

作者信息

Lasses y Ojeda Luis Alberto, Gutiérrez Jorge Luis Torres, Salazar Eduardo

机构信息

Servicio de Cardiología Geriátrica, Instituto Nacional de Cardiologia Ignacio Chávez, México.

出版信息

Arch Cardiol Mex. 2004 Oct-Dec;74(4):315-26.

Abstract

Age is an independent and unmodifiable risk factor for coronary atherosclerosis. In Mexico, coronary heart disease is responsible for 50 % of the deaths for those older than 65 years of age. Aging produces major differences in the presentation, diagnosis, prognosis, and response to therapy in coronary heart disease. The goal of treatment is the prolongation of survival and the improvement of the quality of life. However, in the elderly, the aim of therapy should focus on attaining a meaningful quality of life thus allowing them to be functionally independent. Clinical trials demonstrate conclusively that lowering serum cholesterol levels will reduce the incidence of coronary heart disease irrespective of age. Dietary advise and life-style modifications are the first-line approach in the elderly. When these measures are insufficient to achieve target lipid reductions, statins are the drug of choice. Fibrates may be indicated if triglycerides are high and C-HDL is low. Given the grater coronary risk of older population, the absolute benefit will be greater in the elderly.

摘要

年龄是冠状动脉粥样硬化的一个独立且不可改变的风险因素。在墨西哥,冠心病是65岁以上人群50%死亡的原因。衰老在冠心病的表现、诊断、预后及对治疗的反应方面产生重大差异。治疗的目标是延长生存期和改善生活质量。然而,对于老年人,治疗的目的应侧重于实现有意义的生活质量,从而使他们在功能上保持独立。临床试验确凿地表明,降低血清胆固醇水平将降低冠心病的发病率,与年龄无关。饮食建议和生活方式改变是老年人的一线治疗方法。当这些措施不足以实现目标血脂降低时,他汀类药物是首选药物。如果甘油三酯高且高密度脂蛋白胆固醇低,可使用贝特类药物。鉴于老年人群冠心病风险更高,老年人的绝对获益将更大。

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