Background Cardiovascular disease is one of the main causes of death in patients over 65 years old. Hypercholesterolemia is one of the mayor cardiovascular risk factors (CVRFs). Statin treatment has proved to be highly beneficial in patients with history of coronary disease and stroke. However, its use is controversial in elderly patients.
Purpose To analyse the use of statins in the elderly fragile population admitted to our hospital.
Materials and methods Observational, retrospective study of polymedicated patients over 75 years old, included in a medicines reconciliation programme from January to September 2012.
Data collected were demographics, cardiovascular risk factors including smoking, obesity, hypertension, diabetes, dyslipidaemia, cardiovascular events (AMI, angina, stroke, transient ischaemic attack) and usual treatment.
Results The study included 415 patients (71.8% women), with a mean age of 85 years (76–101), and a mean of 10.14 (6–21) drugs per patient. Out of all patients, 88 were taking statins (41 simvastatin, 32 atorvastatin, 10 pravastatin, 4 lovastatin, 1 fluvastatin). We identified 129 patients with a history of cardiovascular events, 38 (29.4%) of whom were being treated with statins. On one hand, 47 out of 286 patients, who had no history of cardiovascular events, had 3 or more CVRFs, and 23 out of these 47 were being treated with statins. On the other hand, 239 out of the 286 patients had 2 or fewer CVRFs, and 28 (11%) of them were taking hypolipidaemic agents.
Conclusions There is great variability in statins prescribing in elderly patients. According to the NICE guideline and the criteria of our regional health department for the use of lipid-lowering drugs, the decision to treat elderly patients must be individualised depending on comorbidity, chronic diseases, polypharmacy, life expectancy and therapeutic goals. An assessment of the risk/benefit balance is essential every time the patient is hospitalised in order to reduce unnecessary and hazardous polypharmacy. Reconciliation is a useful tool in this assessment.
No conflict of interest.
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