Doctors advised to treat elderly carefully with cholesterol-lowering drugs (statins).

Dubai, United Arab Emirates. (Dr. Noorali Bharwani)
Dubai, United Arab Emirates. (Dr. Noorali Bharwani)

The College of Physicians and Surgeons of Alberta in their newsletter, The Messenger (Jan 11 2017) advised doctors to use statins carefully in the elderly.

If your blood cholesterol level is high then you should ask your doctor if treatment with statins is right for you.

High cholesterol level is a risk factor for heart disease. Statins are drugs that can lower cholesterol level in your blood. If your blood cholesterol level is high then plaques build up on the blood vessel walls. This causes partial or complete blockage of the blood vessels and reduces or blocks blood circulation. Why would you want that to happen?

Statin drugs are commonly used to reduce blood cholesterol level. Examples of statins include – atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).

Statin is effective in lowering the cholesterol level. It may have other health benefits but we do not know everything about it. What is the effect of statin in the elderly is not very well known either. There is a variable quantity of data related to statin use in the elderly, according to the Canadian Cardiovascular Society Guidelines (2016).

The 2016 guidelines continue to recommend treatment for individuals at high risk for cardio-vascular events. This is with the caveat that for adults older than age 75 who are otherwise robust, a discussion should take place regarding the risks and benefits in the context of their individual situation. As I said earlier we do not have much information on the side effects of statin in individuals over the age of 75.

What are the side effects of statin use?

The most common adverse events (1.3 per cent) identified include musculoskeletal events (aches and pains in the muscles) and elevation in liver enzymes. Although not statistically significant, there may be new-onset diabetes and cataract formation. Doctors should monitor their patients for cognitive impairment as well, as it may be associated with statin use.

If you have been on statin prior to age 65, then you can continue to take it after that age if you have had no side effects. Make sure you discuss this with your doctor. You should try to keep total cholesterol level below 6.22 mmol/L. LDL or “bad” cholesterol should be below 3.37 mmol/L.

Taking a statin is one thing but you have to remember lifestyle changes are essential for reducing your risk of heart disease, whether you take a statin or not.

To reduce your risk: 1. Quit smoking and avoid second hand smoke. 2. Eat a healthy diet that’s low in saturated fat, trans fat, refined carbohydrates and salt, and rich in fruits, vegetables, fish, and whole grains. 3. Be physically active, sit less and exercise regularly. 4. Maintain a healthy waist girth: less than 40 inches in men and less than 35 inches in women.

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