Objectives To gain insight into the difference of efficacy and safety of atorvastatin between young-elderly and old-elderly patients with dyslipidemia.
Methods 88 dyslipidemia elderly patients with high risk of cardiovascular and cerebrovascular diseaseswere included and none of them took statins in the previous treatment. All the participants were divided into two groups by age, the young-elderly (65 – 75 years) and old-elderly (76 – 85 years). Every participant took 10mg of atorvastatin every night and low-density lipoprotein cholesterol (LDL-C) level of patients was investigated every four weeks. The dose of atorvastatin given to patients whose LDL-C level was not qualified increased by 10mg every time until 40mg. Different hypolipidemic agent would be applied on these patients if the 40mg atorvastatin per night was not able to qualify their blood lipid level. Serum lipids level and other biochemical parameters were investigated before initiation of treatment and at the 4th, 8th, 12th and 24th-week of treatment respectively. These patients withdrawing from the research for adverse drug reaction were recorded and excluded for the drug effect analysis.
Results 1) For all patients with dyslipidemiathe, average dose of atorvastatin was 18.5mg. It was 19.3mg for the young-elderly group and 18.1mg for the old-elderly group. 76.0% of patients were given 10-20mg of atorvastatin per night and the other 24.0% of patients were given 30-40mg of atorvastatin. At the 24th week of the treatment, the patients’ LDL-C level decreased by 36.3% (P<0.01). The decrease of LDL-C level of the old-elderly group (37.8%) was appreciably more than the young-elderly group (34.4%). Meanwhile, at the end of the treatment, the frequency of patients with qualified LDL-C level of old-elderly (82.9%) was more than of young-elderly group (73.5%), and 78.7% of all the patients with qualified LDL-C level. 2)compared to the baseline, alamine aminotransferase (ALT) presented gradient increase in both groups and reached its peak at 24th week, but less than three times of the normal upper level. Creatinekinase (CPK) levels showed no significant change. 3) There were 9 adverse drug reaction, including 2 gastrointestinal, 4 skelete muscle and 3 other adverse reaction. No significant different rate of adverse reaction was found between the young-elderly and old-elderly.
Conclusions Small dose of atorvastatin decreases the LDL-C level of the elderly patients, especially old-elderly patients. After atorvastatin treatment, the decrease and qualification ratio of LDL-C level of old-elderly patients with dyslipidemia are more than these of young-elderly patients. However, The safety and adverse reaction rate shows no differences between the two groups. Liver enzymes should be monitored during atorvastatin treatment for old population.