Should cholesterol-lowering drug therapy be commenced in a 76-year-old woman who has no pre-existing coronary disease? What about a 76-year-old with pre-existing disease? What should be the duration of such treatment?
I recently saw a patient who has been on simvastatin 20 mg/day for hypercholesterolaemia for the past seven years (since the age of 76). She is now 83 years old and has no history of heart disease, peripheral vascular disease or cerebrovascular disease. Apparently she had a very unfavourable lipid profile and a total cholesterol level above 8.5 mmol/L before she started the medication. However, is it appropriate to continue patients on this medication when they are well into their eighties?