WASHINGTON — A new study has suggested that controlling cholesterol and blood pressure in older patients may lessen the risk of heart disease.
The study by the clinical specialists of the best available evidences, which is reported for in the Canadian Journal of Cardiology, concluded that cholesterol-lowering and blood pressure-controlling therapy are the most effective treatments for reducing cardiovascular events in older adults, but that treatment needs to be individualized.
“Primary prevention trials in younger populations demonstrate small absolute risk reductions over many years, which is difficult to extrapolate to older patients,” explained senior author Michelle M. Graham from the University of Alberta Faculty of Medicine and Dentistry.
Graham added, “Some assume elderly individuals may not have the life expectancy to derive benefit from preventive cardiovascular therapy; however, their baseline level of risk, and subsequent relative risk reduction with appropriate therapy, may actually be higher than in younger patients.”
The review provided substantial evidence that Statin therapy reduces the risk of both myocardial infarction and stroke, although close monitoring of adverse events is needed. Evidence does not support an association between cholesterol-lowering statin therapy and either cognitive impairment or cancer. Adverse effects, like muscle problems and diabetes, do not appear to be elevated in elderly patients.
It showed that potential drug-drug interactions are an important consideration when prescribing statin therapy in older patients because they have a high burden of concurrent medical conditions and are often taking multiple medications. Patients should also be made aware of over-the-counter supplements that may interact with statin therapy.
Blood pressure control is paramount to prevent cardiovascular events and mortality in elderly patients, although the target should be individualized to the patient. Current evidence supports a moderate blood pressure target (systolic blood pressure of 120-150 mmHg) as safe and effective in elderly patients; however, this target should be individualized based on frailty and comorbidities.
Antiplatelet therapy should not be recommended due to a lack of net clinical benefit.
Other interventions shown to reduce the risk of CVD in elderly patients include smoking cessation, physical activity, and maintaining a normal body weight.
“Primary prevention of CVD can improve health and reduce future healthcare costs. Prevention of a first cardiovascular event in elderly patients should be individualized based on consideration of the current evidence, as well as goals of therapy, functionality and/or frailty, comorbidities, and concomitant medications,” stated Dr. Graham.Follow @gorkhapost
Two held on charge of girls trafficking
BETRAWATI— Police have arrested two persons for their alleged involvement in trafficking five adolescent girls aged between 13 to 16 — to India.
The arrestees have been identified as Nirmal Biswakarma (23) of Bheriganga Municipality-12 of Surkhet and Bikas Pyakurel (20) of Chaughada in Likhu Rural Municipality-4 of Nuwakot.
The Surkhet Police had arrested Biswokarma from his home while rescuing the captive girls on Friday and produced him before court on Saturday.
Likewise, acting on the statement of the captive girls, police arrested Pyakurel from Battar Bazaar, Nuwakot on Sunday.
According to District Police Office Chief Basanta Kunwar, a case related to human trafficking was registered against them on Sunday and investigation into the case was expedited from the Nuwakot District Court.
It has been learnt that the duo lured the girls, on their way to play Bhailo on Laxmi Puja, by promising them good jobs in India and transported them to Surkhet.
The rescued girls have been kept at a shelter of Women and Children Service Centre of Nepal Police.Follow @gorkhapost