Mendelson G, Aronow W S
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USA.
J Am Geriatr Soc. 1998 Sep;46(9):1128-31. doi: 10.1111/j.1532-5415.1998.tb06652.x.
To investigate the prevalence of measurement of serum lipids and of utilizing lipid-lowering therapy, when appropriate, in older persons without contraindications to lipid-lowering drugs and with myocardial infarction (MI), stroke, peripheral arterial disease (PAD), and no coronary artery disease (CAD), stroke, or PAD.
A retrospective analysis of charts of all older patients seen from January 1, 1997, through October 15, 1997, was performed to investigate the prevalence of measurement of serum lipids and utilization of lipid-lowering therapy, when appropriate, in older persons without contraindications to lipid-lowering drugs and with MI, stroke, PAD, and no CAD, stroke, or PAD. Patients with life-limiting comorbidities were not included in the study.
An academic, hospital-based geriatrics practice staffed by fellows in a geriatrics training program and full-time faculty geriatricians.
A total of 373 men and 1119 women, mean age 80 +/- 8 years (range 59 to 103 years), were included in the study.
Serum low-density lipoprotein (LDL) cholesterol was measured in 201 of 391 patients (51%) with MI, in 78 of 187 patients (42%) with stroke, in 58 of 115 patients (50%) with PAD, and in 396 of 926 patients (43%) with no CAD, stroke, or PAD. In patients with elevated serum LDL cholesterol levels, lipid-lowering drug therapy was given to eight of 15 patients (53%) <70 years of age with MI, to 34 of 63 patients (54%) 70 to 80 years of age with MI, and to 38 of 81 patients (47%) >80 years of age with MI (P not significant); to three of seven patients (43%) <70 years of age with stroke, to 12 of 26 patients (46%) 70 to 80 years of age with stroke, and to 13 of 32 patients (41%) >80 years of age with stroke (P not significant); to two of four patients (50%) <70 years of age with PAD, to seven of 17 patients (41%) 70 to 80 years of age with PAD, and to 10 of 25 patients (40%) >80 years of age with PAD (P not significant); and to six of 15 patients (40%) <70 years of age with no CAD, stroke, or PAD, to 26 of 70 patients (37%) 70 to 80 years of age with no CAD, stroke or PAD, and to 14 of 47 patients (30%) >80 years of age with no CAD, stroke, or PAD (P not significant). None of the other patients with MI, stroke, PAD, or no CAD, stroke, or PAD was treated with diet or lipid-lowering drugs.
Measurement of serum LDL cholesterol and of appropriate use of lipid-lowering drugs and diet in older patients with MI, stroke, PAD, and no CAD, stroke, or PAD is underutilized in an academic, hospital-based geriatrics practice.
调查在无降脂药物使用禁忌且患有心肌梗死（MI）、中风、外周动脉疾病（PAD）但无冠状动脉疾病（CAD）、中风或PAD的老年人中，血脂测量及适当使用降脂治疗的情况。
对1997年1月1日至1997年10月15日期间就诊的所有老年患者病历进行回顾性分析，以调查在无降脂药物使用禁忌且患有MI、中风、PAD但无CAD、中风或PAD的老年人中，血脂测量及适当使用降脂治疗的情况。患有危及生命的合并症的患者未纳入本研究。
一个由老年医学培训项目的研究员和全职老年病医生组成的学术性、医院老年医学诊所。
共有373名男性和1119名女性，平均年龄80±8岁（范围59至103岁）纳入研究。
在391例MI患者中的201例（51%）、187例中风患者中的78例（42%）、115例PAD患者中的58例（50%）以及926例无CAD、中风或PAD患者中的396例（43%）中测量了血清低密度脂蛋白（LDL）胆固醇。在血清LDL胆固醇水平升高的患者中，年龄<70岁的15例MI患者中有8例（53%）接受了降脂药物治疗，70至80岁的63例MI患者中有第34例（54%），年龄>80岁的81例MI患者中有38例（47%）（P无统计学意义）；年龄<七0岁的7例中风患者中有3例（43%），70至80岁的26例中风患者中有12例（46%），年龄>80岁的32例中风患者中有13例（41%）（P无统计学意义）；年龄<70岁的4例PAD患者中有2例（50%），70至80岁的17例PAD患者中有7例（41%），年龄>80岁的25例PAD患者中有10例（40%）（P无统计学意义）；年龄<70岁的15例无CAD、中风或PAD患者中有6例（40%），70至80岁的70例无CAD中风或PAD患者中有26例（37%），年龄>80岁的47例无CAD、中风或PAD患者中有14例（30%）（P无统计学意义）。其他患有MI、中风、PAD或无CAD、中风或PAD的患者均未接受饮食或降脂药物治疗。
在一个学术性、医院老年医学诊所中，对患有MI、中风、PAD且无CAD、中风或PAD的老年患者进行血清LDL胆固醇测量以及适当使用降脂药物和饮食的情况未得到充分利用。
