Is there an age at which patients no longer benefit from statin therapy? Should there be an upper limit for starting statins or an age at which their use should be discontinued?
—Ron Reese, MPAS, PA-C, Bellevue, Neb.
As always, risk needs to be balanced against potential benefits, and individual circumstances — not just age — should be taken into account. For example, an 80-year-old with dementia and chronic renal failure is not likely to benefit from statin therapy (and might even be harmed by it), whereas a vigorous 90-year-old might be appropriately treated. Nevertheless, there is scant evidence that primary prevention for all elderly patients with hypercholesterolemia would save lives or reduce morbidity, and such treatment would cost billions of dollars a year. The evidence for secondary prevention in elderly patients with known coronary heart disease is much stronger.
—Reuben W. Zimmerman, PA-C (100-1)