Article Impact Level: HIGH Data Quality: STRONG Summary of Journal of the American College of Cardiology, 82(14), 1381–1391. https://doi.org/10.1016/j.jacc.2023.07.027 Dr. Niklas Worm Andersson et al.
Points
- The study aimed to compare the effectiveness of lipid-lowering therapy in reducing LDL cholesterol and preventing cardiovascular disease in older and younger individuals.
- The study included a Danish nationwide cohort of individuals aged 50 years and above who initiated lipid-lowering therapy for primary prevention.
- Each 1 mmol/L reduction in LDL cholesterol was associated with a 23% lower risk of major vascular events in both older (≥70 years) and younger (<70 years) individuals.
- The median reduction in LDL cholesterol was 1.7 mmol/L for both older and younger individuals.
- The study suggests that lowering LDL cholesterol through lipid-lowering therapy provides a similar relative clinical benefit for primary prevention of major vascular events in individuals aged 70 and above as in individuals below 70.
Summary
Lipid-lowering therapy’s effectiveness in reducing low-density lipoprotein (LDL) cholesterol and preventing cardiovascular disease has been well-established in primary prevention trials. However, the evidence regarding its clinical effectiveness in older individuals is limited.
This study aimed to compare the clinical effectiveness of lowering LDL cholesterol through lipid-lowering therapy for primary prevention of cardiovascular disease between older and younger individuals in a Danish nationwide cohort.
The study included individuals aged 50 years and above who had initiated lipid-lowering therapy between January 2008 and October 2017, had no history of atherosclerotic cardiovascular disease, and had baseline and within-1-year LDL cholesterol measurements. The researchers assessed the associated risk of major vascular events in older individuals (70 years and above) compared to younger individuals (below 70 years) by calculating hazard ratios (HRs) per 1 mmol/L reduction in LDL cholesterol.
Among the 16,035 older individuals and 49,155 younger individuals included in the study, the median reduction in LDL cholesterol was 1.7 mmol/L for both groups. Each 1 mmol/L reduction in LDL cholesterol was significantly associated with a 23% lower risk of major vascular events in older individuals (HR: 0.77; 95% CI: 0.71-0.83), which was comparable to the risk reduction observed in younger individuals (HR: 0.76; 95% CI: 0.71-0.80; P value for difference = 0.79). Similar results were found in all secondary analyses.
This study’s findings suggest that lowering LDL cholesterol through lipid-lowering therapy provides a relative clinical benefit for primary prevention of major vascular events in individuals aged 70 years and above, similar to that observed in individuals below 70.
Link to the article: https://www.sciencedirect.com/science/article/abs/pii/S0735109723063945
References Andersson, N. W., Corn, G., Dohlmann, T. L., Melbye, M., Wohlfahrt, J., & Lund, M. (2023). LDL-C Reduction With Lipid-Lowering Therapy for Primary Prevention of Major Vascular Events Among Older Individuals. Journal of the American College of Cardiology, 82(14), 1381–1391. https://doi.org/10.1016/j.jacc.2023.07.027
