Lipid-Lowering Medications in the Elderly
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CME ARTICLE
ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.
CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1.0 category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. Valid November 1, 2005- January 31, 2006. Estimated time: 1 hour
FULL DISCLOSURE POLICY AFFECTING CME ACTIVITIES
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following: Drs. Roberts and Rodriguez have indicated that they have not received financial support for consultation, research or evaluation or have a financial interest relevant to this article. No faculty member has indicated that the presentation will include information on off-label products.
DISCLAIMER STATEMENT
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.
Educational Objectives
1. To identify the indications for statin therapy
2. To identify the contraindications for statin therapy
3. To be able to recommend appropriate lipid management for elderly patients
4. To identify risk factors for rhabdomyolysis in patients taking combination therapy
The final report of the Adult Treatment Panel III (ATP III) guidelines was published in 2001 and provided specific targets and treatment strategies for patients with dyslipidemia.1 Although the target values for lipid levels were not age-specific, ATP III acknowledged that the majority of major coronary events occur in individuals older than 65 years of age.2 Results from the Framingham Heart Study showed that the lifetime risk of coronary heart disease (CHD) increased with rising total cholesterol (TC) levels.3 The lifetime risk for men and women with TC lower than 200 mg/dL and age 60 years was 34% and 20%, respectively, whereas the risk was 51% and 36% for men and women with TC higher than 240 mg/dL.
In 2002, the American Heart Association Council on Clinical Cardiology Subcommittee issued a scientific statement emphasizing the importance of secondary prevention of CHD in elderly individuals, including those older than 75 years of age.4 The evidence showed that older persons as compared with individuals younger than 65 years of age derived equal benefit from interventions and treatments known to reduce risk for cardiovascular and cerebrovascular disease. Interventions such as coronary artery bypass grafting and angioplasty reduced relative risk in older men and women, and treatments such as antihypertensive medications have also been shown to be cardioprotective in this population.
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