Another nonstatin option is bempedoic acid (Nexletol), which reduces the amount of cholesterol the liver produces.Ī diet rich in whole grains, produce, seafood, beans, and nuts is ideal, Hashmi says. ![]() These include alirocumab (Praluent), evolocumab (Repatha, Repatha SureClick), and inclisiran (Leqvio). ![]() If that doesn‘t work, your doctor may recommend an injectable medication to decrease LDL levels. In fact, anyone older than 65 should start with the lowest dosage possible, Hashmi says, in part because “their bodies are less able to metabolize drugs.” Another option, whether a statin isn’t working well enough or side effects are bothersome, is trying a different statin, Hashmi adds.įor those at very high risk for cardiovascular disease, the American College of Cardiology and the American Heart Association say it’s reasonable to add ezetimibe (Zetia), which reduces cholesterol absorption. But note that side effects from statins could be more pronounced in older adults taking the highest dosages, Rosenson says. The higher the score, the more likely it is that you’re developing plaque in the arteries of the heart, “which would be an indication for a stricter diet, exercise, or possibly the addition of medications.”ĭepending on your health and reaction to the medications, increasing the dosage may be reasonable. If you’re on the fence, you might ask your doctor for testing that will reveal your cardiac calcium score, says George Fernaine, MD, section chief of cardiology at NYU Langone Hospital-Brooklyn in New York. The veterans who began taking statins during the seven years that researchers followed them were 20 percent less likely to die from heart disease than those who didn’t take statin drugs. None had diagnosed heart disease at the beginning of the study. Take the study published in 2020 in the Journal of the American Medical Association of 327,000 veterans ages 75 and up. Some research suggests that statin use in this age group may be beneficial. “If you have other risk factors, such as type 2 diabetes or an inflammatory condition like rheumatoid arthritis, you’re in a higher risk category, and statins may be something you need to consider with your doctor,” Rosenson says. Here are key questions and answers.Īs with other age groups, a discussion with your doctor is warranted. So it’s wise to talk with your doctor about your overall health goals and preferences, as well as the scientific evidence. “We don’t just automatically make recommendations based on age anymore,” he says. What to think? The ideal cholesterol levels for you-and whether you rely on lifestyle measures alone or use medication as well to achieve them-should be personalized, says Ardeshir Hashmi, MD, chief of the Center for Geriatric Medicine at the Cleveland Clinic. “The USPSTF isn’t saying you shouldn’t do it, just that there’s not enough research out there to say definitively that you should,” says Robert Rosenson, MD, director of metabolism and lipids at the Icahn School of Medicine at Mount Sinai in New York City. Preventive Services Task Force recently reaffirmed that there’s not enough evidence to recommend-or not recommend-starting statin use in people 76 and older for the prevention of a first heart attack or stroke. Concerns about statin side effects also increase with age, he says. While we are more vulnerable to heart attacks and strokes with age, data showing that statins reduce such risks are “strongest for adults in their 70s and less clear as adults age beyond 80,” says Daniel Forman, MD, chair of the section of cardiology, divisions of geriatrics and cardiology, at the University of Pittsburgh Medical Center. ![]() But there may be some confusion about which older adults should start on statins.
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