Can Middle-Aged and Elderly People Take

Can Middle-Aged and Elderly People Take Statins to Prevent Atherosclerosis?

 

Whether middle-aged and elderly people can take statins to prevent atherosclerosis depends primarily on the results of individual cardiovascular risk assessment, not just age. It must be judged under the guidance of a doctor, and a one-size-fits-all approach is not applicable.

 

Firstly, statins are indeed one of the important means to prevent atherosclerosis, but they are not suitable for all middle-aged and elderly people. For middle-aged and elderly individuals who have not experienced cardiovascular diseases such as coronary heart disease or cerebral infarction (i.e., the "primary prevention" population), doctors will comprehensively assess their 10-year risk of developing cardiovascular diseases by considering multiple factors, including age, blood pressure, blood glucose, blood lipid levels, smoking history, family history of early-onset cardiovascular disease, and the presence of chronic kidney disease.

 

- If assessed as a high-risk or very high-risk population (e.g., concurrent hypertension + diabetes, or a clear family history of atherosclerosis), doctors may recommend taking statins even if their blood lipids are within the conventional reference range. This helps lower "bad cholesterol" (low-density lipoprotein cholesterol), delay or even prevent the progression of atherosclerosis, and reduce the risk of myocardial infarction and cerebral infarction.

- If assessed as a low-risk or medium-low-risk population, lifestyle adjustments (such as a low-salt and low-fat diet, regular exercise, quitting smoking and limiting alcohol intake, and weight control) are usually prioritized for prevention, rather than direct medication.

 

Secondly, the safety of statins must be considered when administered to middle-aged and elderly people. Statins have potential side effects such as mild elevation of liver enzymes and muscle discomfort. Due to the possibility of decreased liver and kidney function and the use of multiple drugs for underlying diseases (which carries the risk of drug interactions) in middle-aged and elderly individuals, doctors will more carefully evaluate their body's tolerance:

 

1. Before medication, indicators such as liver and kidney function will be checked.

2. Regular monitoring will be conducted after starting medication.

3. If unbearable side effects occur, or if there are contraindications such as active liver disease or severe renal insufficiency, the treatment plan will be adjusted or the drug will be discontinued.

 

In addition, for middle-aged and elderly people who have already developed atherosclerosis-related diseases (such as coronary heart disease, cerebral infarction, or carotid artery stenosis) (i.e., the "secondary prevention" population), doctors often recommend taking statins even if their blood lipids are normal. The goal is to stabilize the already formed atherosclerotic plaques, prevent plaque rupture, and this is a necessary measure to prevent recurrence, rather than simply preventing the occurrence of atherosclerosis.

 

In conclusion, the use of statins by middle-aged and elderly people to prevent atherosclerosis is an "individualized medical practice" and cannot be decided by themselves. Doctors must comprehensively evaluate cardiovascular risk, underlying physical diseases, and drug tolerance to determine whether medication is needed and the specific plan. This not only avoids the risk of side effects caused by blind medication but also ensures that necessary preventive measures are not missed for high-risk populations.