老年人降脂治疗与心血管疾病预防。

IF 13 1区 医学 Q1 PHARMACOLOGY & PHARMACY
Drugs Pub Date : 2025-06-01 Epub Date: 2025-05-08 DOI:10.1007/s40265-025-02182-0
Francesco Baratta, Federica Moscucci, Ilaria Lospinuso, Nicholas Cocomello, Alessandra Colantoni, Alessia Di Costanzo, Daniele Tramontano, Laura D'Erasmo, Daniele Pastori, Evaristo Ettorre, Maria Del Ben, Marcello Arca, Giovambattista Desideri
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引用次数: 0

摘要

未来几年,全球80岁及以上人口将达到约5亿,这一人群的心血管疾病预防将成为一项全球性的健康挑战。在循证医学时代,在老年人中使用降脂疗法(LLTs),特别是在一级和二级心血管预防方面,仍然是一个活跃的研究领域。尽管在二级预防中使用llt预防老年人心血管事件复发方面存在广泛共识,但在一级预防中使用llt仍存在相当大的争议。在初级预防中,已经做出了许多努力来改善75岁以上患者的心血管风险分层。近年来,一些特定的风险评分被开发出来,包括老年人系统性冠状动脉风险评估2 (SCORE2-OP)。虽然对于老年人的llt,需要考虑的具体警告很少,但在这一患者群体中,一个重要的挑战是确定负效用风险超过潜在益处的转折点。然而,尽管人们普遍认识到这一问题的重要性,但缺乏关于如何确定应该退出治疗的患者的指导。这篇叙述性综述的目的是检查关于老年患者LLT适应症的知识现状,确定突出的问题,并讨论未来的发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lipid-Lowering Therapy and Cardiovascular Prevention in Elderly.

The global population aged 80 years and older will reach approximately half a billion in the coming years, and cardiovascular prevention in this group of patients will become a global health challenge. In the era of evidence-based medicine, the use of lipid-lowering therapies (LLTs) in the elderly, particularly in primary and secondary cardiovascular prevention, remains an area of active research. Although there is broad consensus on the use of LLTs in the elderly to prevent recurrent cardiovascular events in secondary prevention, there is considerable debate about their use in primary prevention. Many efforts have been made to improve cardiovascular risk stratification in patients over 75 years of age in primary prevention. In recent years, some specific risk scores have been developed, including the Systematic Coronary Risk Evaluation 2 for Older Persons (SCORE2-OP). While there are very few specific warnings to consider for LLTs in the elderly, an important challenge in this patient population is to identify the turning point at which the disutility risk outweighs the potential benefits. However, despite the widespread recognition of the importance of this issue, there is a lack of guidance on how to identify patients who should be withdrawn from therapy. The aim of this narrative review is to examine the current state of knowledge regarding the indications for LLT in elderly patients, identify outstanding issues, and discuss future developments.

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来源期刊
Drugs
Drugs 医学-毒理学
CiteScore
22.70
自引率
0.90%
发文量
134
审稿时长
3-8 weeks
期刊介绍: Drugs is a journal that aims to enhance pharmacotherapy by publishing review and original research articles on key aspects of clinical pharmacology and therapeutics. The journal includes: Leading/current opinion articles providing an overview of contentious or emerging issues. Definitive reviews of drugs and drug classes, and their place in disease management. Therapy in Practice articles including recommendations for specific clinical situations. High-quality, well designed, original clinical research. Adis Drug Evaluations reviewing the properties and place in therapy of both newer and established drugs. AdisInsight Reports summarising development at first global approval. Moreover, the journal offers additional digital features such as animated abstracts, video abstracts, instructional videos, and podcasts to increase visibility and educational value. Plain language summaries accompany articles to assist readers with some knowledge of the field in understanding important medical advances.
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