Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/902
Title: Prescribing statins for cardiovascular disease prevention in the old: an absence of evidence and an absence of guidelines.
Authors: Noaman, Samer
Ibrahim, Joseph E.
Grenfell, Robert
Issue Date: 2014
Publisher: Elsevier
Place of publication: Atlanta, GA
Publication Title: Heart, Lung & Circulation
Volume: 23
Issue: 7
Start Page: 619
End Page: 624
Abstract: Australia's oldest old are potentially being harmed by the under- and over- use of statins. Variations in prescription of statins are in part due to the vacuum of clinical research trial evidence and paucity of contemporary guidelines that are needed to address the use of lipid lowering therapy in the oldest old. There are a few randomised placebo-controlled trials that recruited an older population. Therefore evidence of statins efficacy in the oldest old is based on an extrapolation of results from those studies. The extensive exclusion criteria of those studies, the relative youth of the study participants, the low levels of comorbidity and functional impairment limit the external validity and the generalisability of the findings. Current guidelines are silent or generally non-specific about statin therapy for the oldest old deferring decisions to individual medical practitioners. Life expectancy, time to benefit, functional status and medication related adverse events, polypharmacy, adherence to treatment are factors that need to be considered when forming appropriate guidelines for statin prescription in the very old. Well-designed clinical trials that account for the heterogeneity of this population are needed. While waiting for this research evidence better clinical guidelines are needed to address this issue.
URI: http://hdl.handle.net/11054/902
Resource Link: http://www.sciencedirect.com/science/article/pii/S1443950614001176
ISSN: 1443-9506
Internal ID Number: 00718
Health Subject: AGED, 80 AND OVER
CARDIOVASCULAR DISEASE
ELDERLY
HEALTH SERVICES NEEDS AND DEMAND
OLDER PEOPLE - MEDICAL CARE
LIPIDS
PRESCRIBING
STATINS
Type: Journal Article
Article
Appears in Collections:Research Output

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.