Commentary on 'safety profile of high-dose statin therapy in geriatric patients with stroke'

摘要

For many geriatricians it is not unusual to have patients in their 80s and 90s, and even an occasional centenarian. Patients are living longer, often in spite of multiple diseases. As people age, their comorbidities increase; thus, older patients are more prone to have cardiovascular and cerebrovascular disease, as well as diabetes mellitus, chronic obstructive pulmonary disease (COPD), arthritis, and cancer. Much of our knowledge about treating disease has arisen from clinical trials, which traditionally enroll younger subjects. Clinicians are left to extrapolate the results of these trials to their older patients, which may not be valid for a number of reasons. For example, in a trial comparing tiotropium to salmeterol for patients with COPD, the average age of the subjects was only 63, despite the fact that COPD is a common disease of much older individuals. In this issue of the Southern Medical Journal, Manocha et al report on the adverse effects of high-dose statin therapy in older patients who have had an acute stroke. They point out that much of the information about high-dose statin therapy for stroke came from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, in which the mean age of the subjects was only 63 years.