Cholesterol Drugs for People 75 and Older: When do you need them?

I hope the inclusion of this item in the campaign will remind providers cholesterol lowering drugs shouldn’t be prescribed routinely in older adults and risks versus benefits should be carefully evaluated."
Hosam Kamel, MD, CMD

As the part of the Choosing Wisely campaign, AMDA – The Society for Post-Acute and Long-Term Care Medicine (AMDA) and Consumer Reports Health has created multiple free resources for patients and their families. “Cholesterol drugs for people 75 and older: When you need them – and when you don’t” breaks down when statins might not help, and potentially be harmful. Click here for the Spanish version.

 (AMDA) is proud to be partnering with the American Board of Internal Medicine (ABIM) Foundation's Choosing Wisely® campaign, to encourage conversations between physicians, patients, and other health care stakeholders about medical tests and procedures that may be unnecessary and could be harmful. For more information on AMDA’s Choosing Wisely list and resources click here.

Other free AMDA Choosing Wisely® resources:

  • Advice for caregivers: Treatments and tests for seniors
  • Tests & treatments for urinary tract infections (UTIs) in older people: When you need them – and when you don’t

"It was important to include this item as the number of older adults placed on cholesterol lowering medications has increased significantly lately," said Hosam Kamel, MD, CMD, a member of the Choosing Wisely® workgroup. He added, "While it is true that increased cholesterol has been linked to increased risk of coronary artery disease and stroke, it is important to realize that these bad effects of cholesterol take years to develop. Published data does not support that prescribing cholesterol lowering drugs helps in the primary prevention of cardiovascular disease in older adults. On the other hand, there is data to support beneficial effects in terms of secondary prevention of cardiovascular disease. I personally do not check cholesterol levels in older adults who do not have a history of diabetes, stroke, or coronary artery disease, as there is no data to support that treating elevated cholesterol in such individuals is beneficial." Dr. Kamel observed that it also is important to note that these medications are not without side effects, particularly in the elderly. "There are risks of myopathy, hepatotoxicity, and cognitive impairment among others, not to mention to high cost of these medication and the laboratory tests needed to monitor for potential adverse events," he said. "I hope that the inclusion of this item in the Choosing Wisely® campaign will shed some light on this controversial issue and remind the providers that cholesterol lowering drugs should not be prescribed routinely in older adults and that risks versus benefits should be carefully evaluated when prescribing such medications to older adults."