hypercholesterolemia

Familial Hypercholesterolemia

Nathan Hinkle — Tue, 30 Jun 2026 21:32:37 +0000

Date Added:

June 30, 2026

Journal/Publication:

JAMA

Publisher:

The American Medical Association

Publication Date:

June 29, 2026

Pages:

E1-E3

URL:

Familial Hypercholesterolemia

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

doi: 10.1001/jama.2026.8822

Keywords

MeSH

cardiovascular diseases

RPR Commentary: A review of familial hypercholesterolemia. The heterozygotic form is common enough to be important in primary care. The best screening test is the family history. James W. Mold, MD, MPH

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Familial hypercholesterolemia (FH) is a family of genetic disorders characterized by impaired hepatic clearance of low-density lipoprotein (LDL) particles, due to pathogenic variants that impair LDL receptor function.1,2 Lifelong elevation of LDL cholesterol (LDL-C) results in accelerated atherosclerosis and increased risk of atherosclerotic cardiovascular disease (ASCVD). Worldwide, heterozygous FH affects approximately 1 in 250 to 350 individuals, based on genetic epidemiology studies of pathogenic variants in FH-associated genes.1-3 Homozygous FH is rare, occurring in approximately 1 in 160 000 to 500 000 individuals.2 Among people with untreated heterozygous FH, approximately half of men develop fatal or nonfatal coronary events by age 50 years and approximately one-third of women by age 60 years.

Author/s:

James H. Stein, Matthew C. Tattersall

Managing Hypercholesterolemia in Adults Older Than 75 years Without a History of Atherosclerotic Cardiovascular Disease: An Expert Clinical Consensus From the National Lipid Association and the American Geriatrics Society

Alex Haga — Mon, 14 Apr 2025 18:17:35 +0000

Date Added:

April 14, 2025

Journal/Publication:

Journal of the American Geriatrics Society

Publication Date:

April 10, 2025

URL:

Managing Hypercholesterolemia in Adults Older Than 75 years Without a History of Atherosclerotic Cardiovascular Disease: An Expert Clinical Consensus From the National Lipid Association and the American Geriatrics Society

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1111/jgs.19398

Keywords

hypercholesterolemia

older adult

primary prevention

PMID (1):

40207842

MeSH

cardiovascular diseases

cholesterol

primary prevention

A summary of the evidence and recommendations regarding treatment of people over 75 with statins. James W. Mold, MD, MPH

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The risk of atherosclerotic cardiovascular disease increases with advancing age. Elevated LDL-cholesterol and non-HDL-cholesterol levels remain predictive of incident atherosclerotic cardiovascular events among individuals older than 75 years. Risk prediction among older individuals is less certain because most current risk calculators lack specificity in those older than 75 years and do not adjust for co-morbidities, functional status, frailty, and cognition which significantly impact prognosis in this age group. Data on the benefits and risks of lowering LDL-cholesterol with statins in older patients without atherosclerotic cardiovascular disease are also limited since most primary prevention trials have included mostly younger patients. Available data suggest that statin therapy in older primary prevention patients may reduce atherosclerotic cardiovascular events and that benefits from lipid-lowering with statins outweigh potential risks such as statin-associated muscle symptoms and incident Type 2 diabetes mellitus. While some evidence suggests the possibility that statins may be associated with incident cognitive impairment in older adults, a preponderance of literature indicates neutral or even protective statin-related cognitive effects. Shared decision-making which is recommended for all patients when considering statin therapy is particularly important in older patients. Randomized clinical trial data evaluating the use of non-statin lipid-lowering therapy in older patients are sparse. Deprescribing of lipid-lowering agents may be appropriate for select patients older than 75 years with life-limiting diseases. Finally, a patient-centered approach should be taken when considering primary prevention strategies for older adults.

Author/s:

Vera Bittner, Sunny A Linnebur, Dave L Dixon, Daniel E Forman, Ariel R Green

Statin Use Over 65 Years of Age and All-Cause Mortality: A 10-Year Follow-Up of 19 518 People

Brian Desmarais — Sat, 14 Mar 2020 20:02:11 +0000

Date Added:

March 14, 2020

Journal/Publication:

Journal of the American Geriatrics Society

Publication Date:

October 1, 2019

Issue:

Volume:

URL:

Statin Use Over 65 Years of Age and All-Cause Mortality: A 10-Year Follow-Up of 19 518 People

Type:

Meta-analyses, Reviews, and Guidelines, Practice Management Reviews and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1111/jgs.16060

Keywords

all-cause mortality

cardiovascular events

hypercholesterolemia

older adults

primary prevention

MeSH

Hydroxymethylglutaryl-CoA Reductase Inhibitors

cardiovascular diseases

Statins appear to significantly reduce all-cause mortality in patients over 65 and in those over 75 as well. James W. Mold, MD, MPH

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Abstract

OBJECTIVES

As life expectancy continues to rise, the burden of cardiovascular disease among older people is expected to increase, making cardiovascular prevention in older people an issue of growing interest and public health importance. We aimed to explore the long‐term effects of adherence to statins on mortality and cardiovascular morbidity among older adults.

DESIGN

A historical population‐based cohort study using routinely collected data.

SETTING

Clalit Health Services Northern District.

PARTICIPANTS

We followed members of Clalit Health Services aged 65 years or older who were eligible for primary cardiovascular prevention for a period of 10 years.

MEASUREMENTS

We fitted Cox regression models to assess the association between the adherence to statin therapy and all‐cause mortality and cardiovascular morbidity, adjusting for cardiovascular risk factors and associated morbidity as time‐updated variables.

RESULTS

The analysis included 19 518 older adults followed during 10 years (median = 9.7 y). All‐cause mortality rates were 34% lower among those who had adhered to statin treatment, compared with those who had not (hazard ratio [HR] = .66; 95% confidence interval [CI] = .56‐.79). Adherence to statins was also associated with fewer atherosclerotic cardiovascular disease events (HR = .80; 95% CI = .71‐.81). The benefit of statin use did not diminish among beyond age 75 and was evident for both women and men.

CONCLUSION

Adherence to statins may be associated with reduced mortality and cardiovascular morbidity among older adults, regardless of age and sex. J Am Geriatr Soc 67:2038–2044, 2019

Author/s:

Eilat-Tsanani, S., Schonmann, Y., Mor, E.