Abstract
BACKGROUND: Elderly people have a greater risk than others to develop atherosclerotic disorders. Statins are the most efficient treatments against atherosclerosis; however, the pros and cons of the treatment should be put in balance in regard to the target level of low-density lipoprotein cholesterol (LDL-C). This study evaluates the level of LDL in the Birjand elderly population and determines the achievement of target LDL-C level, according to the American College of Cardiology (ACC) guidelines. METHODS: A retrospective observational study of statin therapy was performed from October 2018 using Birjand community health assessment data of the BLAS project. We used the 2018 ACC/AHA guidelines to determine the achievement of target LDL level in statin treated patients with clinical atherosclerotic cardiovascular diseases (ASCVD), or elderly high risk diabetic patients and dyslipidemia ones, in the Birjand elderly dwellers, stratified by statin treatment intensity. Statin and non-statin users were also compared in terms of demographic and laboratory findings. Mann-Whitney U test and Chi-Square test were used for data analysis. RESULTS: Out of 1418 elderly residents in this study, 683 individuals (48.2%) were male with a mean age of 69.73±7.56 years. The total mean level of LDL-C in elderly participants was 122.83±36.21 mg/dL. The mean level of LDL-C in statin use and none statin use group was 104.97±36.01 and 129.09±34.14, respectively. Only 304 (29.2%) of participants who were eligible for statin administration used the statin. While 69 (18.3%) individuals from 378 (26.7%) were using statin though they were not eligible for it. In the clinical ASCVD group, 39 (28.3%) of elderly participants achieved target LDL-C based on the ACC/AHA guideline. This was 58 (37.4%) for other participants with LDL-C ≥190 mg/dL, diabetic or participants with Framingham Risk Score (FRS) ≥10%. CONCLUSIONS: The majority of patients who were eligible for high or moderate-intensity statin treatment had not received statin. Only one third of clinical ASCVD patients and almost half of high risk patients achieved LDL-C target values. Findings illustrate current treatment may need to be reconsidered in Birjand elderly dwellers treated with statin and physicians, should be updated on the use of statins.