Lipid-lowering therapy for elderly patients at risk for coronary events and stroke.

Hyperlipidemia continues to be a major risk factor for cardiovascular diseases, particularly coronary heart disease, in the elderly population. Despite the fact that hyperlipidemia does not seem to be a major risk factor for stroke, therapy for hyperlipidemia, especially with statins, has clearly been demonstrated to reduce both coronary heart disease events and stroke, with the most convincing data being for the elderly population. Although we review some safety concerns with statin therapy applicable to the elderly, statins alone or with other proved therapies, including fibrates, niacin, and exercise training, have been demonstrated to reduce major cardiovascular diseases, including coronary heart disease and stroke in the elderly. In addition, this therapy can be safely administered to most elderly patients and seems to have either neutral or slightly beneficial effects on dementia. Therefore, aggressive lipid treatment, particularly with statins, is needed in the primary and secondary prevention of cardiovascular diseases in the elderly.