A third of very elderly Americans ‘on statins without evidence’

On August 25, 2015 By RhoniIn #Medical, MedicalLeave a commentEdit

A third of very elderly Americans ‘on statins without evidence’

Published: Tuesday 25 August 2015 at 12am PST

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Statins:

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Statins are a group of medicines that can help lower the level of low-densit-lipoprotein (LDL) cholesterol “bad cholesterol” in the blood. Having a high level of LDL cholesterol is potentially dangerous, as it can lead to a hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD).

• What are Statins? Find out about statins, a group of medicines used to lower LDL cholesterol levels in the blood. Learn about how they work, together with their benefits and side effects.

Cardiovascular / Cardiology:

Cardiovascular / Cardiology The latest cardiovascular and cardiology research from prestigious universities and journals throughout the world.

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The cardiovascular system is comprised of the heart and the network of arteries, veins, and capillaries that carries blood throughout the body. The average adult male has between 5-6 liters of blood while the average adult female has 4-5 liters. Blood transports oxygen and essential nutrients to all of the living cells in the body, and also carries waste products from the tissues to the systems of the body through which they are removed.

• What is blood pressure? How is it measured? Learn all about blood pressure and what is meant by a reading that is too high or too low. Our article also explains how blood pressure is measured and how our bodies maintain it.
• How To Check Your Pulse Find out about the most effective ways in which to find and check a pulse, whether it’s your own or someone else’s.
• What Is Heart Rate? An introduction to heart rate, a measurement of how many times a person’s heart beats per minute. Learn about the how to measure your pulse, what a normal resting heart rate is and how exercise affects it.

Heart Disease:

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Heart disease describes several problems related to plaque buildup in the walls of the arteries, atherosclerosis, irregular heartbeat or heart valve problems. Types of heart disease include coronary artery disease, cardiomyopathy, enlarged heart, heart attack, atrial fibrillation, heart valve disease, congenital heart disease, heart muscle disease, pericarditis, pericardial effusion, Marfan syndrome and heart murmurs. Heart disease is the leading cause of death in the US.

• What is Atrial Fibrillation? Our article explains all about atrial fibrillation – a heart condition that causes an irregular heartbeat. We look at the causes, symptoms and treatments.
• What is heart disease? Heart disease is a term that covers a range of disorders that affect the heart. Find out all about the different types of heart disease, the causes and the latest research.

Types of atrial fibrillationThere are three types of atrial fibrillation – paroxysmal atrial fibrillation, persistent atrial fibrillation and longstanding persistent atrial fibrillation.

DiagnosisA health care professional can diagnose atrial fibrillation from an ECG, Holter monitor, event recorder, echocardiogram, blood test or X-ray.

CausesThe most common causes of atrial fibrillation include hypertension, congenital heart disease, cardiomyopathy, pericarditis and atrial flutter.

ComplicationsA patient with atrial fibrillation is twice as likely to develop a stroke compared to other people.

What is atrial fibrillation?Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate.

SymptomsSymptoms of atrial fibrillation include a fast heartbeat over 140 beats per minute, dizziness, confusion, palpitations, chest pains and weakness.

TreatmentThere is a wide range of available treatments for atrial fibrillation. Patients may be treated by their doctor or a cardiologist.

Types of atrial fibrillationThere are three types of atrial fibrillation – paroxysmal atrial fibrillation, persistent atrial fibrillation and longstanding persistent atrial fibrillation.

DiagnosisA health care professional can diagnose atrial fibrillation from an ECG, Holter monitor, event recorder, echocardiogram, blood test or X-ray.

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Statins are being used “without any evidence from testing” among very elderly people in the US, with levels of prescribing rising from 8.8% in 1999-2000 to 34.1% in 2011-2012 for people who have no vascular disease.

Researchers say the prescribing of statins for the elderly should be exercised with caution.

The oldest age group, over 79 years, have the highest rate of statin use in the US, according to the study published in JAMA Internal Medicine, but this had not been investigated previously.
The research, carried out by Dr. Michael Johansen, of Ohio State University in Columbus, and Dr. Lee Green, of the University of Alberta in Canada, used data from the 1999-2012 Medical Expenditure Panel Survey.
The annual survey is nationally representative of the civilian population living in the community in the US – those who are not hospitalized.
The authors conclude:
“Although the medical community has embraced the use of statins for primary prevention in the very elderly, caution should be exercised given the potential dangers of expanding marginally effective treatments to untested populations.”
The survey sample included 13,099 individuals. The rates of vascular disease rose from 27.6% in 1999-2000 to 43.7% in 2011-2012.
“Despite a lack of clear recommendation for statin use in the primary prevention of the very elderly,” says the research letter, there was a “large” increase in the use of the cholesterol-lowering medications in spite of “little randomized evidence to guide the use.”
Primary prevention is defined as statin use in individuals without vascular disease – with no history of coronary heart disease (CHD), stroke or peripheral vascular disease (PVD).
Secondary prevention use is defined as prescription for those who already have vascular disease, the level of which prescribing increased in 2007 after questions became more frequently asked about CHD and stroke.

Survey interviews

The survey used in the study consisted of five interviews over 2 years. Participants reported demographics, medical conditions and prescription drug information.
The analysis included all individuals older than 79 years without liver disease. Prescriptions were verified using pharmacy data.
The proportion of patients using atorvastatin peaked in 2005-2006 and then steadily declined, while the proportion using simvastatin was steady until 2007-2008 before rising. The proportion taking rosuvastatin steadily increased after introduction.
A journal editorial in July said that lowering cholesterol with statins had become an “unquestionable” means for lowering cardiovascular risk, but that the question had remained of “when, in whom and how to lower cholesterol.”
The article was commenting on a study finding that new guidelines have imp