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
Nirmala Panta’s murder accused held after 24 days
KANCHANPUR — Police in Kanchanpur have made public an accused arrested in connection with the murder of 13-year-old Nirmala Panta of Kanchanpur’s Bhimdatta Municipality.
Dilip Singh Bista, 41, of Baghphanta, Bhimdatta Municipality was made public at a press conference at the DPO. Bista was arrested on Saturday,according to the District Police Office Spokesperson Deputy Superintendent of Police Gyan Bahadur Sethi.
Nirmala was found dead in a sugarcane field on July 27, a day after she had gone to her friend’s home to get a notebook.
Bista,who was released from prison last year after serving nine years for murdering his brother-in-law Narayansingh Thapa, works as a daily-wage labourer.
According to Bista’s statement to police, he helped Nirmala fix her bicycle chain before raping and killing her on July 26. He told police that killed her to avoid being arrested again.Follow @gorkhapost