Cholesterol reduction in special subgroups of elderly, heart failure, renal failure, low cardiovascular risk
Pécsi Tudományegyetem, Klinikai Központ, I. sz. Belgyógyászati Klinika, Endokrinológiai és Anyagcsere Tanszék, Pécs
The acceptance of the overall efficacy and safety of cholesterol lowering drugs is evident from the broadening indications and deepening target values of the 2019 European Dyslipidemia Guidelines. However, there are groups of patients, such as with non-preserved EF ischemic heart failure or severe renal insufficiency, where statins cannot significantly improve poor cardiovascular prognosis. With regard to the secondary prevention of the elderly, the European guidelines are essentially non-discriminatory, but there is a conservative trend in primary prevention, although the available evidences suggest that neither the relative effect nor the risk are significantly different from that of the less elderly. This concept may change by the results of ongoing dedicated statin trials. With the advent of the lifelong risk concept, reduction of non-high-cholesterol levels by medicines of low risk individuals have also become to be considered.