LDL-C reduction prevents CVD in older adults

Lowering bad cholesterol can help prevent major vascular events in older individuals aged ≥70 years similarly as those aged <70 years, suggests a recent study.

“Reducing low-density lipoprotein cholesterol (LDL-C) with lipid-lowering therapy has consistently been shown to lower the risk of cardiovascular disease in primary prevention trials where the majority of individuals are aged <70 years,” the authors said.

This study compared the clinical effectiveness of LDL-C reduction by means of lipid-lowering therapy for the primary prevention of cardiovascular disease (CVD) among older and younger individuals in a Danish nationwide cohort.

The authors included individuals aged ≥50 years who had initiated lipid-lowering therapy from 1 January 2008 to 31 October 2017, had no history of atherosclerotic CVD, and had LDL-C measurements at baseline and within 1 year. They then assessed the related risk of major vascular events among older adults (≥70 years) by hazard ratio (HR) per 1-mmol/L reduction in LDL-C vs younger adults (<70 years).

The median LDL-C reduction for both older (n=16,035) and younger individuals (n=49,155) was 1.7 mmol/L. Each 1-mmol/L decrease in LDL-C among older adults resulted in a 23-precent reduction in the risk of major vascular events (HR, 0.77, 95 percent confidence interval [CI], 0.71‒0.83), which was similar to that of younger individuals (HR, 0.76, 95 percent CI, 0.71‒0.80; p=0.79).

All secondary analyses revealed similar results.

“Our study supports a relative clinical benefit of lowering LDL-C for primary prevention of major vascular events in individuals aged ≥70 years similarly as in individuals aged <70 years,” the authors said.