Nair Ajith P, Darrow Bruce
Cardiovascular Institute, Mount Sinai Medical Center, One Gustave L. Levy Place, NY 10029, USA.
Endocrinol Metab Clin North Am. 2009 Mar;38(1):185-206. doi: 10.1016/j.ecl.2008.11.003.
Elderly individuals are at higher risk for cardiovascular events, and thus this population stands to gain a greater reduction in events from lipid therapy than younger individuals. Multiple primary and secondary prevention trials have demonstrated that the benefits of statins in geriatric patients are equivalent to, or greater than, those seen in younger patients. Combination therapy with non-statin agents should be considered in patients who do not meet cholesterol goals or who have concomitant hypertriglyceridemia or low levels of high-density lipoprotein cholesterol. Although increased side effects may occur with high-dose statin therapy, careful vigilance of drug interactions and limiting polypharmacy can reduce these effects.
老年人发生心血管事件的风险更高，因此与年轻人相比，这一人群从脂质治疗中获得的事件减少幅度更大。多项一级和二级预防试验表明，他汀类药物在老年患者中的益处等同于或大于在年轻患者中观察到的益处。对于未达到胆固醇目标或伴有高甘油三酯血症或高密度脂蛋白胆固醇水平低的患者，应考虑使用非他汀类药物进行联合治疗。尽管高剂量他汀类药物治疗可能会增加副作用，但仔细监测药物相互作用并限制联合用药可以减少这些影响。
