Lipid management in the elderly: An analysis of the importance of lipid-lowering therapy in the prevention of coronary heart disease.

It is advisable to understand lipid-lowering therapy for the elderly: Although coronary heart disease (CHD) has been proven to be a condition that does not only affect the elderly, its incidence is significantly higher in the elderly than in younger people. While the relative risk of CHD caused by elevated serum cholesterol levels is slightly lower in the elderly than in younger or middle-aged individuals, the incidence of CHD events due to hypercholesterolemia (unstable angina, acute myocardial infarction, and sudden cardiac death) is higher in the elderly than in younger or middle-aged individuals. Studies using coronary angiography have concluded that even with progressive coronary atherosclerosis, lipid-lowering therapy can still mitigate its progression. Lipid-lowering therapy can also control the risk of CHD in the elderly, achieving a significant reduction.

However, not all elderly patients are suitable for strong cholesterol-lowering therapy. For example, patients who are very old or have serious comorbidities (such as chronic congestive heart failure, dementia, advanced cerebrovascular disease, or active malignant tumors) should be avoided. For elderly individuals with other health issues or those without coronary heart disease who desire longevity, elevated serum cholesterol should be treated with lipid-lowering therapy without hesitation. The extent to which cholesterol should be lowered depends on the risk of coronary heart disease. In other words, the more coronary heart disease risk factors present, the more intensive the cholesterol-lowering treatment should be. Patients with coronary heart disease or multiple risk factors should supplement their medication with dietary therapy. For elderly patients with a low risk of coronary heart disease, dietary therapy and physical exercise are highly effective, while lipid-lowering drugs are less effective.