Controversy over Hyperlipidemia Treatment

Jocalyn P. Clark, MSc

The link between hyperlipidemia (elevated cholesterol levels) and coronary artery disease (CAD) is well established in adult populations, for which there are a variety of preventative and treatment strategies. Research has not typically included older patients in large numbers, therefore extrapolation of evidence to the care of older people can be difficult. Controversy exists about both diet and drug options for cholesterol treatment in the elderly, especially among those 75 years and older, suggesting that careful consideration and caution is required in determining 'whom' and 'how' to treat. Since the majority of cardiovascular disease occurs above the age of 65, especially in women, treatment of hyperlipidemia in the elderly is an important challenge.

In considering treatment options for hyperlipidemia in elderly patients, a recent review in Drugs and Aging suggests that target low density lipoprotein cholesterol (LDL-C) levels should be <3.2 mmol/L, with total cholesterol levels aiming to be <5.2 mmol/L.