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Statins for the Elderly - efficacy ??
  Statin Treatment for Older Adults: The Impact of the 2013 ACC/AHA Cholesterol Guidelines - new analysis: "the evidence is lacking for older adults without major cardiovascular risk aside from age" - (05/25/17)
"the evidence is lacking for older adults without major cardiovascular risk aside from age"

Again, careful examination of the eight studies selected for this meta-analysis shows that all of the studies involved patients with high cardiovascular risk ranging from hypercholesterolemia to diabetes mellitus. Therefore, this meta-analysis only shows benefit for a subpopulation of older adults, and is not generalizable to older adults without high cardiovascular risk.


Significant association between statin-associated myalgia and vitamin D deficiency among treated HIV-infected patients - (04/11/17) ......To conclude, low vitamin D levels seem to be associated with the development of statin-induced myalgia in HIV-infected patients under cART like in the general population, but additional, enlarged, and controlled studies are needed to examine the potential role of vitamin D deficiency in the reduced statin tolerance by HIV-infected people.
Study Casts Doubt on Need for Statins in the 'Healthy Old' - But specialists cite research flaws, limitations - (05/25/17)
Dr. Robert Rosenson is director of cardiometabolic disorders at the Icahn School of Medicine at Mount Sinai. He said the new study is flawed because its conclusions rely on data from a very small number of patients. For example, the analysis of people 75 and older included only 375 people taking pravastatin and 351 in the control group. "That's such a small number to detect difference in events, let alone mortality when you're dealing with a low-potency statin," Rosenson said.
"The only merit to the study is that it raises questions that haven't been adequately answered," said Dr. Robert Eckel, an AHA spokesman. "This is not the kind of evidence that should influence guidelines about statin therapy in adults 65 and older," said Eckel, chair of atherosclerosis at the University of Colorado School of Medicine. For the study, Han and his colleagues analyzed data from a clinical trial conducted from 1994 to 2002, called the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT).
Statins - Analysis of Efficacy and Safety in Patients Aged 65-75 Years at Randomization [from Jules: relatively low risk, with Diabetes] - (05/25/17)
Statin (JUPITER study) in Elderly with Relatively Low Risk Factors - (05/25/17)
Statins effects in Older Adults Risks/Benefits - Primary Prevention / ALLHAT-LLT Study "patients without atherosclerotic cardiovascular disease" - (05/25/17)
This secondary analysis of the subset of older adults who participated in the ALLHAT-LLT showed no benefit of primary prevention for all-cause mortality or CHD events when pravastatin was initiated for adults 65 years and older with moderate hyperlipidemia and hypertension. A nonsignificant trend toward increased all-cause mortality with pravastatin was observed among adults 75 years and older.
Our study found that newly administered statin use for primary prevention had no benefit on all-cause mortality or CHD events compared with UC in the subset of adults 65 years and older with hypertension and moderate hypercholesterolemia in the ALLHAT-LLT. We noted a nonsignificant direction toward increased all-cause mortality with the use of pravastatin in the age group 75 years and older, but there was no significant interaction between treatment group and age. The use of statins may be producing untoward effects in the function or health of older adults that could offset any possible cardiovascular benefit. Statins may have an effect on the physical or mental functioning of older adults, and studies26,27have shown that any negative effect on function places older adults at higher risk for functional decline and death. Older adults are at increased risk for statin-induced muscle problems; the risk of hospitalization for rhabdomyolysis in patients 65 years and older is more than 5 times higher than that in younger adults.28It has also been suggested that statins have negative effects on energy and fatigue with exertion.29Therefore, it is possible that, for vulnerable older adults, statins may have negative effects on function. Evidence has suggested that statin use may have negative effects on cognition, particularly in adults with mild cognitive impairment or dementia.30However, a recent major review of the efficacy and safety of statins using trial data found no effect of statins on incident dementia or on cognitive function.31However, that study fails to acknowledge that current trial data do not include many people 80 years and older or older frail adults; other individual trials were underpowered to identify the harms of statin therapy.32



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