Denke M A, Grundy S M
University of Texas Southwestern Medical Center, Dallas.
Ann Intern Med. 1990 May 15;112(10):780-92. doi: 10.7326/0003-4819-112-10-780.
Of all age groups, men and women over 60 years of age have the highest prevalence of elevated serum cholesterol levels. Now that detection and treatment of high serum cholesterol levels are increasing, we need a rational approach to managing elevated cholesterol levels in elderly patients. Recent data indicate that high total cholesterol and low-density lipoprotein levels predict risk for coronary heart disease in patients over 60 years of age. However, selecting appropriate candidates for cholesterol-lowering therapy requires clinical judgment of the relative risks and benefits of each therapy and consideration of each patient's overall health status as well as of competing risks. Active medical management of high cholesterol levels, therefore, should be restricted to a limited fraction of elderly patients who are most likely to benefit from long-term therapy. The first line of treatment is diet modification; however, drug therapy for appropriate patients is not contraindicated because of age alone.
在所有年龄组中，60岁以上的男性和女性血清胆固醇水平升高的患病率最高。鉴于高血清胆固醇水平的检测和治疗正在增加，我们需要一种合理的方法来管理老年患者升高的胆固醇水平。最近的数据表明，高总胆固醇和低密度脂蛋白水平可预测60岁以上患者患冠心病的风险。然而，选择合适的降胆固醇治疗候选人需要对每种治疗的相对风险和益处进行临床判断，并考虑每个患者的整体健康状况以及竞争风险。因此，高胆固醇水平的积极医学管理应仅限于最有可能从长期治疗中受益的一小部分老年患者。一线治疗是饮食调整；然而，对于合适的患者，药物治疗并不因年龄本身而被禁忌。
