Book contents
- Frontmatter
- Contents
- Editorial Advisory Committee
- Contributors
- Acknowledgments
- 1 Essential Principles in the Care of the Elderly
- 2 Assessment of the Older Patient
- 3 Prevention for Older Adults
- 4 Common Complaints in the Elderly
- 5 Appropriate Use of Medications in the Elderly
- 6 Nutrition and Aging
- 7 Using Exercise as Medicine for Older Adults
- 8 Diabetes Mellitus in the Older Adult
- 9 Lipid Management in Older Patients
- 10 Hypertension
- 11 Diagnosis and Management of Heart Disease in the Elderly
- 12 Peripheral Arterial Disease in the Elderly
- 13 Stroke in the Older Adult
- 14 Neurological Problems in the Elderly
- 15 Recognition and Management of Delirium
- 16 Evaluation and Management of Dementia
- 17 Clinical Geropsychiatry
- 18 Alcohol and Other Drug Abuse in Older Patients
- 19 Aging in Adults with Developmental Disabilities
- 20 Pulmonary Issues in the Elderly
- 21 Gastroenterological Disease in the Older Adult
- 22 Serious Infections in the Elderly
- 23 Human Immunodeficiency Virus in the Elderly
- 24 Principles of Fluid and Electrolyte Balance and Renal Disorders in the Older Patient
- 25 Urological Issues in Older Adults
- 26 Urinary Incontinence
- 27 Geriatric Gynecology
- 28 Disorders of the Endocrine Glands
- 29 Osteoporosis and Other Metabolic Disorders of the Skeleton in Aging
- 30 Common Rheumatic Diseases in the Elderly
- 31 Musculoskeletal Injuries in the Elderly
- 32 Foot Health for the Elderly: Podogeriatric Overview
- 33 Geriatric Dermatology
- 34 Pressure Ulcers: Practical Considerations in Prevention and Treatment
- 35 Anemia and Other Hematological Problems of the Elderly
- 36 Cancer in the Elderly
- 37 Eye Problems of the Aged
- 38 Geriatric Ear, Nose, and Throat Problems
- 39 Geriatric Dentistry
- 40 Surgical Principles in the Aged
- 41 Rehabilitation in Older Adults
- 42 Community-Based Long-Term Care
- 43 Institutional Long-Term Care
- 44 Care for the Elderly Patient at the End of Life
- 45 Assessment of Decision-Making Capacity
- 46 Injuries in Older Adults
- 47 The Mistreatment of Older Adults
- 48 Driving and the Older Adult
- 49 Integrative Medicine in the Care of the Elderly
- 50 Successful Aging: Optimizing Strategies for Primary Care Geriatrics
- 51 Cell Biology and Physiology of Aging
- 52 Implications of an Aging Society
- 53 Ethnogeriatrics
- 54 Retirement
- 55 Geriatric Sexuality
- 56 The Elderly, Their Families, and Their Caregivers
- 57 Systematic Approaches to Preventing Errors in the Care of the Elderly
- 58 Health Care Organization and Financing
- 59 Advance Care Planning: Values and Families in End-of-Life Care
- 60 Ethical Decision Making in Geriatric Medicine
- Index
- Plate section
9 - Lipid Management in Older Patients
Published online by Cambridge University Press: 19 May 2010
- Frontmatter
- Contents
- Editorial Advisory Committee
- Contributors
- Acknowledgments
- 1 Essential Principles in the Care of the Elderly
- 2 Assessment of the Older Patient
- 3 Prevention for Older Adults
- 4 Common Complaints in the Elderly
- 5 Appropriate Use of Medications in the Elderly
- 6 Nutrition and Aging
- 7 Using Exercise as Medicine for Older Adults
- 8 Diabetes Mellitus in the Older Adult
- 9 Lipid Management in Older Patients
- 10 Hypertension
- 11 Diagnosis and Management of Heart Disease in the Elderly
- 12 Peripheral Arterial Disease in the Elderly
- 13 Stroke in the Older Adult
- 14 Neurological Problems in the Elderly
- 15 Recognition and Management of Delirium
- 16 Evaluation and Management of Dementia
- 17 Clinical Geropsychiatry
- 18 Alcohol and Other Drug Abuse in Older Patients
- 19 Aging in Adults with Developmental Disabilities
- 20 Pulmonary Issues in the Elderly
- 21 Gastroenterological Disease in the Older Adult
- 22 Serious Infections in the Elderly
- 23 Human Immunodeficiency Virus in the Elderly
- 24 Principles of Fluid and Electrolyte Balance and Renal Disorders in the Older Patient
- 25 Urological Issues in Older Adults
- 26 Urinary Incontinence
- 27 Geriatric Gynecology
- 28 Disorders of the Endocrine Glands
- 29 Osteoporosis and Other Metabolic Disorders of the Skeleton in Aging
- 30 Common Rheumatic Diseases in the Elderly
- 31 Musculoskeletal Injuries in the Elderly
- 32 Foot Health for the Elderly: Podogeriatric Overview
- 33 Geriatric Dermatology
- 34 Pressure Ulcers: Practical Considerations in Prevention and Treatment
- 35 Anemia and Other Hematological Problems of the Elderly
- 36 Cancer in the Elderly
- 37 Eye Problems of the Aged
- 38 Geriatric Ear, Nose, and Throat Problems
- 39 Geriatric Dentistry
- 40 Surgical Principles in the Aged
- 41 Rehabilitation in Older Adults
- 42 Community-Based Long-Term Care
- 43 Institutional Long-Term Care
- 44 Care for the Elderly Patient at the End of Life
- 45 Assessment of Decision-Making Capacity
- 46 Injuries in Older Adults
- 47 The Mistreatment of Older Adults
- 48 Driving and the Older Adult
- 49 Integrative Medicine in the Care of the Elderly
- 50 Successful Aging: Optimizing Strategies for Primary Care Geriatrics
- 51 Cell Biology and Physiology of Aging
- 52 Implications of an Aging Society
- 53 Ethnogeriatrics
- 54 Retirement
- 55 Geriatric Sexuality
- 56 The Elderly, Their Families, and Their Caregivers
- 57 Systematic Approaches to Preventing Errors in the Care of the Elderly
- 58 Health Care Organization and Financing
- 59 Advance Care Planning: Values and Families in End-of-Life Care
- 60 Ethical Decision Making in Geriatric Medicine
- Index
- Plate section
Summary
OVERVIEW
This chapter will introduce issues related to management of lipid disorders in older patients to reduce the risk of atherosclerosis and cardiovascular disease (CVD). Because lipid metabolism and regulation do not vary greatly between younger and older people, age-related influences on cardiovascular risk and lipoprotein-mediated disease processes will be our central theme. In addition, aspects of appropriate pharmacotherapy and support of treatment adherence will balance out the overall review.
AGE AND CARDIOVASCULAR RISK
Clinicians typically approach the task of assessing cardiovascular risk by focusing on patient age as an obvious “nonmodifiable risk factor.” The Framingham risk score estimates 10-year absolute risk for CVD events and age contributes enormously to the end result, given that indeed age is the greatest contributor to absolute cardiovascular risk. This may be related to the multiple observations that have concluded atherosclerosis as a process that begins early in life. Advanced age reflects an increased duration of exposure to various risk factors and an accumulation of coronary disease burden. The Framingham Risk Score is less robust in the elderly (age >70 years) as this group has already had their “age-based” exposure. A comparison of the risk factor counting method as outlined in the National Cholesterol Education Program Guidelines to a multivariate analysis demonstrated that these guidelines underestimate risk among more than 5 million persons with fewer than two risk factors. Compared to individuals whose classification was unchanged, those misclassified as low risk were older and more likely to be male.
- Type
- Chapter
- Information
- Reichel's Care of the ElderlyClinical Aspects of Aging, pp. 89 - 95Publisher: Cambridge University PressPrint publication year: 2009