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Titolo:
TIME TRENDS IN THE USE OF CHOLESTEROL-LOWERING AGENTS IN OLDER ADULTS- THE CARDIOVASCULAR HEALTH STUDY
Autore:
LEMAITRE RN; FURBERG CD; NEWMAN AB; HULLEY SB; GORDON DJ; GOTTDIENER JS; MCDONALD RH; PSATY BM;
Indirizzi:
CARDIOVASC HLTH RES UNIT,METROPOLITAN PK,EAST TOWER,SUITE 1360,1730 MINOR SEATTLE WA 98101 UNIV WASHINGTON,DEPT MED SEATTLE WA 00000 UNIV WASHINGTON,DEPT EPIDEMIOL SEATTLE WA 98195 UNIV WASHINGTON,DEPT HLTH SERV SEATTLE WA 98195 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PUBL HLTH SCI WINSTON SALEMNC 27103 UNIV PITTSBURGH,DEPT MED PITTSBURGH PA 00000 UNIV PITTSBURGH,DEPT EPIDEMIOL PITTSBURGH PA 15261 UNIV CALIF SAN FRANCISCO,DEPT EPIDEMIOL & BIOSTAT SAN FRANCISCO CA 94143 NHLBI,DIV HEART & VASC DIS BETHESDA MD 20892 GEORGETOWN UNIV HOSP,DIV CARDIOL WASHINGTON DC 20007
Titolo Testata:
Archives of internal medicine
fascicolo: 16, volume: 158, anno: 1998,
pagine: 1761 - 1768
SICI:
0003-9926(1998)158:16<1761:TTITUO>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; DENSITY-LIPOPROTEIN CHOLESTEROL; MYOCARDIAL-INFARCTION; SCREENING GUIDELINES; ELDERLY PATIENTS; COMMON-SENSE; PRAVASTATIN; HYPERCHOLESTEROLEMIA; REDUCTION; PROGRAM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
36
Recensione:
Indirizzi per estratti:
Citazione:
R.N. Lemaitre et al., "TIME TRENDS IN THE USE OF CHOLESTEROL-LOWERING AGENTS IN OLDER ADULTS- THE CARDIOVASCULAR HEALTH STUDY", Archives of internal medicine, 158(16), 1998, pp. 1761-1768

Abstract

Objectives: To describe recent temporal patterns of cholesterol-lowering medication use and the characteristics that may have influenced the initiation of cholesterol-lowering therapy among those aged 65 yearsor older. Subjects and Methods: A cohort of 5201 adults 65 years or older were examined annually between June 1989 and May 196. We added 687 African American adults to the cohort in 1992-1993. We measured blood lipid levels at baseline and for the original cohort in the third year of follow-up. We assessed the use of cholesterol-lowering drugs at each visit. Results: The prevalence of cholesterol-lowering drug use in 1989-1990 was 4.5% among the men and 5.9% among the women; these figures increased over the next 6 years to 8.1% and 10.0%, respectively, in 1995-1996. There was a 4-fold increase in the use of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors during the 6 years of follow-up, from 1.9% of all participants in 1989-1990 to 7.5% in 1995-1996. The use of bile acid sequestrants, nicotinic acid, and probucol declined from initial levels of less than 1% each. Among the participants who were untreated in 1989-1990, but eligible for cholesterol-lowering therapy after a trial of dietary therapy according to the 1993 guidelines of the National Cholesterol Education Panel, less than20% initiated drug therapy in the 6 years of follow-up, even among subjects with a history of coronary heart disease. Among participants untreated at baseline but eligible for either cholesterol-lowering therapy or dietary therapy, initiation of cholesterol-lowering drug therapywas directly associated with total cholesterol levels, hypertension, and a history of coronary heart disease, and was inversely related to age, high-density lipoprotein cholesterol levels, and difficulties with activities of daily living. Other characteristics that form the basis of the 1993 National Cholesterol Education Panel guidelines-diabetes, smoking, family history of premature coronary heart disease, and total number of risk factors-were not associated with the initiation of cholesterol-lowering drug therapy. Conclusions: Given the clinical trial evidence for benefit, those aged 65 to 75 years and with prior coronary heart disease appeared undertreated with cholesterol-lowering drugtherapy.

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Documento generato il 24/11/20 alle ore 13:30:34