Cardiovascular diseases are very common among people over the age of 80, and the number of cholesterol patients is clearly growing.
"This has resulted in the need to issue instructions on the use of the most common cholesterol-lowering drugs, statins, in this age group. We also wish to clear up any previous misunderstandings," says Timo Strandberg, Professor of Geriatrics at the University of Helsinki, who is involved in a broad-based Finnish study on the subject.
Controlled trials have shown that lowering cholesterol levels clearly reduces both cardiovascular disease and mortality in men and women under the age of 80. According to the researchers, it is therefore important that patients at increased risk for vascular disease receive treatment sufficiently early, well before they turn 80.
The researchers also stress that such treatment should not end when the patient turns 80.
A decade ahead
Randomised trials have not yet been conducted on treatment started after the patient has turned 80. Instead, the commencement of treatment among patients in this age group is based on other data. Statin treatment has proved particularly beneficial to patients who already suffer from a vascular disease.
"The need for cholesterol treatment among those over the age of 80 must always be assessed individually because the health of these patients may vary from excellent to very poor," Strandberg explains.
"The average life expectancy of 80-year-olds ranges from eight to ten years. This provides sufficient time for statin treatment to make a difference, and the prevention of cardiovascular disease improves one’s quality of life."
Although the elderly usually tolerate statins well, the researchers recommend that doses be moderate. In addition, the possible side effects of statins must be closely monitored, and potential drug interactions must be carefully considered because elderly patients often take a variety of drugs.
Patient decisions based on correct information
"It is important to respect each patient’s view of his or her need for treatment," Strandberg says.
But at the same time, patients’ decisions regarding treatment must be based on correct information.
"For example," Strandberg emphasises, "it is important that patients understand that statins do not cause dementia!"
The study, published in the Journal of the American Medical Association, was a cooperative venture between the University of Helsinki, the Hospital District of Helsinki and Uusimaa, the University of Oulu, the North Karelia Central Hospital, the Finnish Institute of Occupational Health and Mehiläinen.