Dyslipidaemia in elderly and stroke patients

Lowering of cholesterol containing atherogenic particles through lipid lowering therapies is of outmost important in both in the elderly age group and younger age group in reducing the cardiovascular risk. This chapter summarizes the current existing knowledge regarding the factors which affects the key decision-making process in patients with older age, and also in special circumstance where the direct evidence of benefit for cholesterol lowering is lacking. Effort has been made to briefly summarize the recommendations to the patient and his/her family based on risk stratification of atherosclerotic versus non-atherosclerotic cardiovascular disease, comorbidity burden, quality of life, survival prognosis, lifestyle/socioeconomic status and presence of frailty. Here in this chapter, we have collated and presented the available robust clinical trial evidence which is very much necessary for the assessment of risk versus benefit for hypolipidemic drugs in the elderly age group.

While plethora of pharmacological interventions has evolved including statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, Inclisiran etc., but it is essential to establish lipid-lowering therapy goals based on the stroke subtype and the presence of comorbidities. Here in this section we have reviewed the collated clinical evidences for optimal drug regimen recommendation for elderly stroke patients for both primary and secondary prevention.