Lipid lowering in patients 75 years and older

doi:10.4330/wjc.v13.i10.526

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Oct 26, 2021 (publication date) through Mar 12, 2026

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World Journal of Cardiology

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1949-8462

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World J Cardiol. Oct 26, 2021; 13(10): 526-532
Published online Oct 26, 2021. doi: 10.4330/wjc.v13.i10.526

Lipid lowering in patients 75 years and older

Umidakhon Makhmudova, P Christian Schulze, Harry R Davis, Oliver Weingärtner

Umidakhon Makhmudova, P Christian Schulze, Oliver Weingärtner, Klinik für Innere Medizin I, Universitätsklinikum Jena, Jena 07747, Germany

Harry R Davis, Synergy Partners RD Solutions, Synergy Partners RD Solutions, Gaithersburg, MD 20850, United States

Author contributions: Makhmudova U, Schulze PC, Davis HR and Weingärtner O wrote the manuscript and designed figures; All authors have read and approved the final manuscript.

Conflict-of-interest statement: The authors declare that there are no conflicts of interest.

Corresponding author: Oliver Weingärtner, MD, PhD, Adjunct Professor, Klinik für Innere Medizin I, Universitätsklinikum Jena, Jena 07747, Germany. oliver.weingaertner@med.uni-jena.de

Received: April 1, 2021
Peer-review started: April 1, 2021
First decision: July 6, 2021
Revised: July 12, 2021
Accepted: September 8, 2021
Article in press: September 8, 2021
Published online: October 26, 2021
Processing time: 201 Days and 15.4 Hours

Abstract

More than twenty years ago, knowledge about the importance of cholesterol absorption and the potential therapeutic effect of its inhibition led to the discovery and clinical application of the first and only cholesterol absorption inhibitor to date – ezetimibe. Since then, ezetimibe has become a well-recognized player in lipid-lowering therapy. Recent findings of IMPROVE-IT and EWTOPIA 75 imply that elderly patients over the age of 75 years in particular benefit from ezetimibe. This review summarizes the evidence, discusses the possible underlying pathophysiological mechanisms and calls for a change in future dyslipidemia guidelines.

Keywords: Cholesterol; Cholesterol absorption; Cholesterol synthesis; Ezetimibe; Elderly

Core Tip: The review summarizes the evidence of lipid-lowering therapies in patients 75 years and older, and discusses the possible underlying pathophysiological mechanisms and calls for a change in future dyslipidemia guidelines.