Use of Cholesterol-Lowering Therapy by Elderly Adults After Myocardial Infarction

Abstract
THE NUMBER of elderly Americans who have survived an acute myocardial infarction (AMI) is steadily increasing. Major randomized clinical trials1-3 using 3-hydroxy-3-methylglutaryl coenyzme A reductase inhibitors (ie, statins) to lower cholesterol levels have demonstrated improved survival and cardiac outcomes in patients with coronary heart disease. Focused analyses4-7 of patients aged 65 to 75 years have confirmed that the relative benefits of lowering cholesterol levels for these patients are similar to the benefits for younger patients. In fact, because older patients with coronary heart disease have a substantially higher rate of subsequent cardiac events than younger patients, cholesterol-lowering drug therapy can prevent approximately twice as many cardiovascular events and deaths in older patients than in patients younger than 65 years.5,6 Thus, the National Cholesterol Education Program (NCEP)8 has strongly recommended that cholesterol-lowering therapy be used for secondary prevention of cardiovascular events in patients aged 65 to 75 years with coronary heart disease.