Dyslipidemia: How Aggressively to Intervene in the Older Patient?

Lipid abnormalities are extremely prevalent among the elderly, a group at very high risk for cardiovascular disorders. Accordingly, the treatment guidelines of the National Cholesterol Education Program Adult Treatment Panel do not suggest that lipid management be any less aggressive in older patients than in younger ones. Management decisions focus on the calculated low-density lipoprotein cholesterol level as part of a full fasting lipid panel. Dietary counseling remains an important element in the management of lipid disorders, but almost all elderly patients require medications to reach their lipid goals. The statins are the mainstay of treatment for most patients, but some will require additional agents, such as a fibrate, niacin, ezetimibe, fish oil, or a bile acid sequestrant.