Lipid Research Clinic, Departments of Epidemiology & Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
Drugs Aging. 2009;26(11):917-31. doi: 10.2165/11318270-000000000-00000.
Although HMG-CoA reductase inhibitors (statins) have been shown to reduce the risk of cardiovascular events in patients aged 65-80 years who have clinical cardiovascular disease, fewer data are available for elderly patients without cardiovascular disease. Treatment guidelines recommend a low-density lipoprotein cholesterol goal of <100 mg/dL for those with cardiovascular disease or diabetes mellitus but vary in their recommendations for primary prevention. Moderate-dose statins have been shown to be effective and safe in properly selected elderly patients up to the age of 80 years. High-dose statins have also been shown to be effective and reasonably safe in patients without significant co-morbidities up to the age of 75 years. With advancing age, the potential for benefit from cholesterol-lowering treatment needs to be weighed against the increasing risk of muscle and hepatic toxicity, as well as competing causes of morbidity and mortality.
虽然已证实 HMG-CoA 还原酶抑制剂（他汀类药物）可降低 65-80 岁有临床心血管疾病的患者发生心血管事件的风险，但对于无心血管疾病的老年患者，相关数据较少。治疗指南建议，有心血管疾病或糖尿病的患者，低密度脂蛋白胆固醇目标值应 <100mg/dL，但对于一级预防的推荐有所不同。适当选择的 80 岁以下老年患者使用中等剂量他汀类药物已被证实有效且安全。在无明显合并症的患者中，高剂量他汀类药物也已被证实有效且在合理范围内安全，年龄可达 75 岁。随着年龄的增长，需要权衡降脂治疗的潜在获益与肌肉和肝毒性风险增加以及其他导致发病率和死亡率的因素。
