Vnitr Lek 2000, 46(9):551-554

[Dyslipoproteinemia in elderly patients].

V Bláha, D Solichová, Z Zadák: Klinika gerontologická a metabolická Fakultní nemocnice UK, Hradec Králové.

Dyslipoproteinaemia as one among classical risk factors of atherosclerotic cardiovascular diseases has been involved also in the aged. The predictive value of total cholesterol, LDL-cholesterol, HDL-cholesterol, triacylglycerols and lipoprotein (a) is preserved. There are several objective data from post-hoc analyses of prospective clinical studies AFCAPS/TexCAPS, 4S, CARE, LIPID a WOSCOPS, which addressed the need of treatment of dyslipoproteinaemia in the aged. The guidelines are not unique, but they stress an individual approach. We usually continue to treat genetic forms of dyslipidaemia. Candidates of treatment are also patients with diagnose of coronary heart disease (CHD) and sublinic form of CHD, where the treatment has been effective within two years and lead to decrease of CHD risk up to 45%. The individuals with CHD and other CHD risk factors absent would be treated less often. The diet is an basic treatment option of hypolipidemic intervention in the elderly. We do not omit exercise. The pharmacotherapy of dyslipidaemia is used for the individuals with high risk. We usually start with lower dose of fibrates or statins and monitor for adverse effects of such therapy.