Statin therapy for elderly patients should be assessed for each individual
Clinical Research in Practice The Journal of Team Hippocrates
A critical appraisal and clinical application of Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. An 83-year old African-American male presented with weakness and fatigue for the past several months. He had a BMI of 28 and a past medical history of COPD, osteoarthritis, GERD, chronic kidney disease, hypertension, and coronary artery disease. He had a 20 pack-year history of smoking and quit 15 years
... and quit 15 years prior. In addition to the chief complaint, the patient reported chronic pain of his knees and lower back along with occasional muscle aches. The patient was admitted and treated for anemia and occult gastrointestinal bleeding. His list of home medications included atorvastatin. As this was reviewed with the patient, he inquired about the purpose of his medications and any potential side effects. He expressed concern over the large number of medications he was on and asked if it was necessary to remain on a statin. Clinical Question Do the benefits outweigh the harms when placing patients greater than 65 years of age on statin therapy for cardiovascular risk reduction? A search for original research studies was done using the keywords "statin", "elderly", and ">65" in PubMed and Google Scholar. For each relevant article that was found, the references were reviewed looking for more original research studies that addressed the clinical question. The 2013 atherosclerotic cardiovascular disease (ASCVD) risk reduction guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) 1 were also reviewed for recommendations on statin therapy in adults greater than 65 years of age and the evidence on which they were based. GONG, N. Critical review and clinical application of SHEPHERD J, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial.