Acharjee Subroto, Welty Francine K
Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Clin Interv Aging. 2008;3(2):299-314. doi: 10.2147/cia.s2442.
Elderly individuals are at increased risk of coronary heart disease (CHD) and account for a majority of CHD deaths. Several clinical trials have assessed the beneficial effects of statins in individuals with, or at risk of developing, CHD. These trials provide evidence that statins reduce risk and improve clinical outcomes even in older patients; however, statin therapy remains under-utilized among the aged. Atorvastatin has been widely investigated among the older subjects and has the greatest magnitude of favorable effects on clinical outcomes of CHD. The pharmacokinetic properties of atorvastatin allow it to be used every other day, a factor which may decrease adverse events and be especially important in the elderly. The purpose of this article is to review the evidence available from randomized clinical trials regarding the safety and efficacy of atorvastatin in primary and secondary prevention of CHD and stroke in older patients and to discuss issues such as drug interactions, patient compliance and cost-effectiveness, which affect prescription of lipid-lowering therapy among older patients.
老年人患冠心病（CHD）的风险增加，且冠心病死亡病例大多为老年人。多项临床试验评估了他汀类药物对患有冠心病或有患冠心病风险的个体的有益作用。这些试验证明，即使在老年患者中，他汀类药物也能降低风险并改善临床结局；然而，他汀类药物治疗在老年人中的使用率仍然较低。阿托伐他汀已在老年受试者中得到广泛研究，对冠心病的临床结局具有最大程度的有利影响。阿托伐他汀的药代动力学特性使其可以隔日服用，这一因素可能会减少不良事件，对老年人尤为重要。本文的目的是回顾随机临床试验中有关阿托伐他汀在老年患者冠心病和中风一级及二级预防中的安全性和有效性的现有证据，并讨论影响老年患者降脂治疗处方的药物相互作用、患者依从性和成本效益等问题。
