Don't routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.
|Rationale and Comments:||There is no evidence that hypercholesterolemia, or low high-density lipoprotein cholesterol is an important risk factor for all-cause mortality, coronary heart disease mortality, or hospitalization for myocardial infarction or unstable angina in persons older than 70 years. In fact, studies show that elderly patients with the lowest cholesterol have the highest mortality after adjusting other risk factors. In addition, a less favorable risk-benefit ratio may be seen for patients older than 85, where benefits may be more diminished and risks from statin drugs more increased (cognitive impairment, falls, neuropathy and muscle damage).|
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