Barretto A C, Wajngarten M, Gebara O C, do Serro Azul J B, Pierri H, Nussbacher A, Pivotto L, Bellotti G, Pileggi F
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Arq Bras Cardiol. 1996 Aug;67(2):93-8.
To evaluate the influence of age on response to pravastatin treatment in patients treated by community physicians.
According to age, 873 patients were divided in three groups: group A with ages ranging from 45 to 59 years (n = 55), group B with ages from 60 to 64 years (n = 182) and group C with ages from 65 to 70 years (n = 143). After four weeks only with diet orientation, patients received 10 mg/day of pravastatin for 12 weeks.
There was a greater prevalence of risk factors in elderly patients: hypertension (45.7%, 54.4% and 57.1% in groups A, B and C respectively p = 0.0165), diabetes mellitus (9.3%, 17.6% and 25.8% respectively in groups A, B and C p < 0.0001), and previous heart disease (23.1%, 34.3% and 34.7% in groups A, B and C respectively p < 0.001). During the period of diet orientation there was a similar total cholesterol reduction in the three groups (about 10.5%), the reduction reached 30.0% with the introduction of pravastatin for 12 weeks. Low density cholesterol level decreased during the diet period in the three groups (about 10.5%), pravastatin prescription induced further reduction (about 31.7%). The high density cholesterol level (HDL) increased significantly with pravastatin treatment (12.7%). After pravastatin treatment the increase in HDL levels was more significantly among those patients with initial low levels of HDL (< 35 mg/dL) in the three groups.
In patients selected by community physicians to receive lipid lowering therapy, increased age was associated with greater prevalence of risk factors and heart disease. Regardless of age, there was a good response to pravastatin treatment, however less than half of patients had received treatment prior to the protocol.
评估年龄对社区医生治疗的患者接受普伐他汀治疗反应的影响。
根据年龄，873例患者分为三组：A组年龄在45至59岁之间（n = 55），B组年龄在60至64岁之间（n = 182），C组年龄在65至70岁之间（n = 143）。仅进行四周饮食指导后，患者接受10毫克/天的普伐他汀治疗12周。
老年患者中危险因素的患病率更高：高血压（A、B、C组分别为45.7%、54.4%和57.1%，p = 0.0165）、糖尿病（A、B、C组分别为9.3%、17.6%和25.8%，p < 0.0001）以及既往心脏病（A、B、C组分别为23.1%、34.3%和34.7%，p < 0.001）。在饮食指导期间，三组的总胆固醇降低情况相似（约10.5%），引入普伐他汀治疗12周后降低幅度达到30.0%。三组在饮食期间低密度胆固醇水平均下降（约10.5%），服用普伐他汀后进一步降低（约31.7%）。高密度胆固醇水平（HDL）在普伐他汀治疗后显著升高（12.7%）。在三组中，初始HDL水平较低（< 35毫克/分升）的患者接受普伐他汀治疗后HDL水平升高更为显著。
在社区医生选择接受降脂治疗的患者中，年龄增加与危险因素和心脏病的患病率增加相关。无论年龄如何，患者对普伐他汀治疗反应良好，但不到一半的患者在方案实施前接受过治疗。
