Are Statins Indicated in Senior Citizens? A Review of Statin Therapy in the Elderly

The use of statin therapy in atherosclerotic cardiovascular disease (ASCVD) has demonstrated substantial improvement in morbidity and mortality of the aging population. Despite exhaustive studies demonstrating the benefits of statin therapy linking lower cholesterol levels to decreased vascular events, statin guidelines vary greatly with age, and recommendations are unclear regarding initiation and discontinuation of statin therapy in patients 65 years and older. Data suggest that statins are highly effective at secondary prevention of major cardiovascular events and development of coronary heart disease in patients with a history of vascular disease or risk factors such as diabetes mellitus, hypertension, hypercholesterolemia, or smoking. Therefore, patients who meet these criteria, regardless of age, should begin statin therapy. There is also some evidence to suggest that statin therapy may be beneficial in primary prevention of major cardiovascular events, although these data are not as well studied as secondary prevention use of statin therapy, and should therefore be individualized for each patient.