Amit Jhaveri1, Rachel A Sibley1, Erica S Spatz2, John Dodson3,4. 1. Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA. 2. Divison of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, USA. 3. Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, 227 East 30th Street, TRB 851, New York, NY, 10016, USA. John.Dodson@nyumc.org. 4. Division of Healthcare Delivery Science, Department of Population Health, New York University School of Medicine, New York, NY, USA. John.Dodson@nyumc.org.
Abstract
PURPOSE OF REVIEW: The utility of aspirin and statins for primary prevention of atherosclerotic cardiovascular disease remains ambiguous in older adults. Current guidelines and recent data are vague and inconclusive. This review seeks to summarize the landscape of primary prevention of cardiovascular disease in older adults and explore the role of shared decision making. RECENT FINDINGS: Observational data suggest potential benefit of statin therapy in older adults. Aspirin is presently not recommended for primary prevention based on evidence from recent clinical trials. The implementation of shared decision making and decision aids in routine clinical practice remains challenging but may rise in coming years. Clinical trial data on the horizon may aid in solidifying guideline therapy for statin use. However, in the face of uncertainty, shared decision making between provider and patient should be utilized to determine whether pharmacotherapy may benefit older adults. Decision aids are an effective tool to guide this process.
PURPOSE OF REVIEW: The utility of aspirin and statins for primary prevention of atherosclerotic cardiovascular disease remains ambiguous in older adults. Current guidelines and recent data are vague and inconclusive. This review seeks to summarize the landscape of primary prevention of cardiovascular disease in older adults and explore the role of shared decision making. RECENT FINDINGS: Observational data suggest potential benefit of statin therapy in older adults. Aspirin is presently not recommended for primary prevention based on evidence from recent clinical trials. The implementation of shared decision making and decision aids in routine clinical practice remains challenging but may rise in coming years. Clinical trial data on the horizon may aid in solidifying guideline therapy for statin use. However, in the face of uncertainty, shared decision making between provider and patient should be utilized to determine whether pharmacotherapy may benefit older adults. Decision aids are an effective tool to guide this process.
Authors: Scott M Grundy; Neil J Stone; Alison L Bailey; Craig Beam; Kim K Birtcher; Roger S Blumenthal; Lynne T Braun; Sarah de Ferranti; Joseph Faiella-Tommasino; Daniel E Forman; Ronald Goldberg; Paul A Heidenreich; Mark A Hlatky; Daniel W Jones; Donald Lloyd-Jones; Nuria Lopez-Pajares; Chiadi E Ndumele; Carl E Orringer; Carmen A Peralta; Joseph J Saseen; Sidney C Smith; Laurence Sperling; Salim S Virani; Joseph Yeboah Journal: Circulation Date: 2018-11-10 Impact factor: 29.690
Authors: Nelleke M Korteland; Yunus Ahmed; David R Koolbergen; Marjan Brouwer; Frederiek de Heer; Jolanda Kluin; Eline F Bruggemans; Robert J M Klautz; Anne M Stiggelbout; Jeroen J J Bucx; Jolien W Roos-Hesselink; Peter Polak; Thanasie Markou; Inge van den Broek; Rene Ligthart; Ad J J C Bogers; Johanna J M Takkenberg Journal: Circ Cardiovasc Qual Outcomes Date: 2017-02-22
Authors: Yuichiro Yano; Christopher J O'Donnell; Lewis Kuller; Maryam Kavousi; Raimund Erbel; Hongyan Ning; Ralph D'Agostino; Anne B Newman; Khurram Nasir; Albert Hofman; Nils Lehmann; Klodian Dhana; Ron Blankstein; Udo Hoffmann; Stefan Möhlenkamp; Joseph M Massaro; Amir-Abbas Mahabadi; Joao A C Lima; M Arfan Ikram; Karl-Heinz Jöckel; Oscar H Franco; Kiang Liu; Donald Lloyd-Jones; Philip Greenland Journal: JAMA Cardiol Date: 2017-09-01 Impact factor: 14.676
Authors: Daniel E Forman; James A de Lemos; Leslee J Shaw; David B Reuben; Radmila Lyubarova; Eric D Peterson; John A Spertus; Susan Zieman; Marcel E Salive; Michael W Rich Journal: J Am Coll Cardiol Date: 2020-09-29 Impact factor: 24.094