The Present and Future
Review Topic of the Week
Primary Prevention With Statins in the Elderly

https://doi.org/10.1016/j.jacc.2017.10.080Get rights and content
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Abstract

The burden of atherosclerotic cardiovascular disease (ASCVD) in high-income countries is mostly borne by the elderly. With increasing life expectancy, clear guidance on sensible use of statin therapy to prevent a first and potentially devastating ASCVD event is critically important to ensure a healthy aging population. Since 2013, 5 major North American and European guidelines on statin use in primary prevention of ASCVD have been released by the American College of Cardiology/American Heart Association, the UK National Institute for Health and Care Excellence, the Canadian Cardiovascular Society, U.S. Preventive Services Task Force, and the European Society of Cardiology/European Atherosclerosis Society. Guidance on using statin therapy in primary ASCVD prevention in the growing elderly population (>65 years of age) differs markedly. The authors discuss the discrepant recommendations, place them into the context of available evidence, and identify circumstances in which uncertainty may hamper the appropriate use of statins in the elderly.

Key Words

ACC
AHA
atherosclerosis
cardiovascular disease
ESC
guideline

Abbreviations and Acronyms

ACC/AHA
American College of Cardiology/American Heart Association
ASCVD
atherosclerotic cardiovascular disease
CCS
Canadian Cardiovascular Society
CI
confidence interval
ESC/EAS
European Society of Cardiology/European Atherosclerosis Society
MI
myocardial infarction
NICE
National Institute for Health and Care Excellence
RCT
randomized controlled trial
RR
relative risk
SAS
statin-associated symptoms
SCORE
Systematic COronary Risk Evaluation

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Both authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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