Horodinschi Ruxandra-Nicoleta, Stanescu Ana Maria Alexandra, Bratu Ovidiu Gabriel, Pantea Stoian Anca, Radavoi Daniel George, Diaconu Camelia Cristina
University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania.
Clinical Emergency Hospital of Bucharest, 14461 Bucharest, Romania.
Medicina (Kaunas). 2019 Oct 30;55(11):721. doi: 10.3390/medicina55110721.
Elderly patients are a special category of patients, due to the physiological changes induced by age, the great number of comorbidities and drug treatment and last, but not least, to the cognitive dysfunction frequently encountered in this population. Cardiovascular disease is the most important cause of morbidity and mortality in elderly individuals worldwide. The rate of cardiovascular events increases after 65 years in men and after 75 years in women. Myocardial infarction and stroke are the leading disorders caused by atherosclerosis, that lead to death or functional incapacity. Elderly people have a greater risk to develop atherosclerotic cardiovascular disease. The incidence and prevalence of atherosclerosis increase with age and the number of cardiovascular events is higher in elderly patients. The most efficient treatment against atherosclerosis is the treatment with statins, that has been shown to decrease the risk both of stroke and coronary artery disease in all age groups. The advantages of the treatment become evident after at least one year of treatment. Primary prevention is the most important way of preventing cardiovascular disease in elderly individuals, by promoting a healthy lifestyle and reducing the risk factors. Secondary prevention after a stroke or myocardial infarction includes mandatory a statin, to diminish the risk of a recurrent cardiovascular event. The possible side effects of statin therapy are diabetes mellitus, myopathy, and rhabdomyolysis, hepatotoxicity. The side effects of the treatment are more likely to occur in elderly patients, due to their multiple associated comorbidities and drugs that may interact with statins. In elderly people, the benefits and disadvantages of the treatment with statins should be put in balance, especially in those receiving high doses of statins.
老年患者是一类特殊的患者群体，这是由于年龄引起的生理变化、大量的合并症和药物治疗，以及最后但同样重要的是，该人群中经常出现的认知功能障碍。心血管疾病是全球老年个体发病和死亡的最重要原因。男性65岁后、女性75岁后心血管事件发生率增加。心肌梗死和中风是由动脉粥样硬化引起的主要疾病，可导致死亡或功能丧失。老年人患动脉粥样硬化性心血管疾病的风险更高。动脉粥样硬化的发病率和患病率随年龄增长而增加，老年患者的心血管事件数量更高。对抗动脉粥样硬化最有效的治疗方法是使用他汀类药物，已证明其可降低所有年龄组中风和冠状动脉疾病的风险。治疗的益处至少在治疗一年后才会显现出来。一级预防是预防老年个体心血管疾病的最重要方式，即通过促进健康的生活方式和降低风险因素来实现。中风或心肌梗死后的二级预防包括必须使用他汀类药物，以降低心血管事件复发的风险。他汀类药物治疗可能的副作用包括糖尿病、肌病、横纹肌溶解、肝毒性。由于老年患者存在多种合并症以及可能与他汀类药物相互作用的药物，治疗的副作用在老年患者中更易发生。在老年人中，应权衡他汀类药物治疗的利弊，尤其是在接受高剂量他汀类药物治疗的患者中。
