Dyslipoproteinemia in the Elderly: Should It Be Treated?

Coronary heart disease (CHD) is the leading cause of death in both older men and women. Elevated cholesterol and especially elevated low-density lipoprotein/high-density lipoprotein (LDL/HDL) ratios may be significant risk factors, although less so than among middle-aged persons. No formal study has yet demonstrated the efficacy of lipid lowering in the prevention of CHD in persons over 65 or in women at any age. The maximal age for treatment of an elevated LDL/HDL ratio is probably age 70 or less. In older women, the most effective and cost-effective pharmacologic means to prevent atherosclerosis and heart attacks is most likely estrogen therapy.