Was a statin useful for major cardiovascular prevention in older adults?
Evaluation of information from older adults who participated in a scientific trial confirmed no advantage of a statin for all-cause mortality or coronary coronary heart illness occasions when a statin was began for major prevention in older adults with hypertension and reasonably excessive ldl cholesterol, in keeping with a brand new article revealed by JAMA Inner Drugs.
Many older sufferers take statins for major cardiovascular prevention however knowledge are restricted on the dangers and advantages of statins for major prevention on this age group. Enhancing the understanding of preventive interventions in older sufferers has implications for well being care and its prices.
Benjamin H. Han, M.D., M.P.H., of the New York College College of Drugs, and coauthors analyzed knowledge from older adults within the Lipid-Decreasing Trial (LLT) element of the Antihypertensive and Lipid-Decreasing Therapy to Forestall Coronary heart Assault Trial (ALLHAT-LLT), which was carried out from 1994 to 2002.
The authors used an analytical pattern that included 2,867 adults with hypertension however with out baseline atherosclerotic heart problems (plaque build-up within the arteries). Of the two,867 adults, 1,467 have been within the pravastatin sodium group (40 mg per day) and 1,400 acquired standard care from their major care doctor to decrease ldl cholesterol.
The authors report no advantage of pravastatin for the principle end result of all-cause mortality or secondary outcomes of coronary coronary heart illness occasions and cause-specific mortality. Extra deaths occurred within the pravastatin group than within the standard care group (141 vs. 130) amongst adults 65 to 74 and amongst adults 75 and older (92 vs. 65). There have been 76 CHD occasions within the pravastatin group in contrast with 89 within the standard care group amongst adults 65 to 74 and 31 CHD occasions in contrast with 39 amongst adults 75 and older, in keeping with the outcomes. Stroke, coronary heart failure and most cancers charges have been related within the two therapy teams for each age teams.
Authors observe limitations of the present examine, which embody its design as a submit hoc secondary evaluation of a trial of a subgroup of sufferers.
"No profit was discovered when a statin was given for major prevention to older adults. Therapy suggestions needs to be individualized for this inhabitants," the article concludes.
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Benjamin H. Han, M.D., M.P.H., of the New York College College of Drugs, and coauthors analyzed knowledge from older adults within the Lipid-Decreasing Trial (LLT) element of the Antihypertensive and Lipid-Decreasing Therapy to Forestall Coronary heart Assault Trial (ALLHAT-LLT), which was carried out from 1994 to 2002.
The authors used an analytical pattern that included 2,867 adults with hypertension however with out baseline atherosclerotic heart problems (plaque build-up within the arteries). Of the two,867 adults, 1,467 have been within the pravastatin sodium group (40 mg per day) and 1,400 acquired standard care from their major care doctor to decrease ldl cholesterol.
The authors report no advantage of pravastatin for the principle end result of all-cause mortality or secondary outcomes of coronary coronary heart illness occasions and cause-specific mortality. Extra deaths occurred within the pravastatin group than within the standard care group (141 vs. 130) amongst adults 65 to 74 and amongst adults 75 and older (92 vs. 65). There have been 76 CHD occasions within the pravastatin group in contrast with 89 within the standard care group amongst adults 65 to 74 and 31 CHD occasions in contrast with 39 amongst adults 75 and older, in keeping with the outcomes. Stroke, coronary heart failure and most cancers charges have been related within the two therapy teams for each age teams.
Authors observe limitations of the present examine, which embody its design as a submit hoc secondary evaluation of a trial of a subgroup of sufferers.
"No profit was discovered when a statin was given for major prevention to older adults. Therapy suggestions needs to be individualized for this inhabitants," the article concludes.
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