dyslipidemia is common in the elderly, but due to concerns about safety, the elderly have insufficient use of fat-regulating drugs and a high rate of stopping drugs.
Recently released the "Chinese Expert Consensus on the Management of Dyslipidemia in the Elderly" pointed out that lipid regulation treatment is an important measure to prevent and treat atherosclerotic cardiovascular disease (ASCVD) in the elderly. For ultra-high-risk patients, LDL-C should be reduced to 1. mmol/L4. The or below should be reduced by 50%.
Ultra-high risk is patients with any of the following factors: recurrent ASCVD events, coronary multivascular lesions, recent acute coronary syndrome, LDL-C4.9 mmol/L and diabetes .
Table 1 target value of lipid regulation treatment for elderly people [mmol/L (mg/dl)]
And the 2019 ESC blood lipid guidelines standard and the Chinese "Expert Consensus on the Management of Clinical Pathways in Patients with Acute Coronary Syndrome" suggest that LDL-C in ultra-high-risk patients should be 1.mmol/L4, and and have a decrease of ≥50% from the baseline level.
When the tolerant dose of statin LDL-C does not meet the standard, edzeimebu or PCSK9 inhibitor can be added.
Consensus suggests that the elderly adhere to regular aerobic exercise, and pay attention to avoid damage and falls caused by exercise when exercising.
does not recommend that the elderly strictly control their diet and lose weight.
For elderly people who have rapidly decreased total cholesterol or LDL-C after taking small doses of statins, they should check whether they have tumors and other wastistic diseases.
For those with high cardiovascular risk at age 75, life expectancy, weak status, combined disease, liver and kidney function, economic factors, etc., to weigh the benefits of lipid regulation treatment, drug interactions, adverse reactions, and personal willingness to decide whether to use medium and low-dose statins.
Source:
[1] Liu Meilin, Zhang Yumeng, Fu Zhifang, et al. Chinese expert consensus on the management of dyslipidemia in the elderly. Chinese Journal of Internal Medicine , 2022, 61(10): 1095-1118.
[2] Chinese Medical Association Cardiovascular Physician Branch. Expert consensus on the management of blood lipids in patients with acute coronary syndrome . Chinese Journal of Circulation , 2020, 35: 941-947. DOI:10.3969/j.issn.1000-3614.2020.10.001. [Scan or long press the QR code to see the original text]
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