Residents on Statins Meet Cholesterol Goals

Abstract

CHARLOTTE, N.C. — Nearly 9 of 10 nursing home residents taking statins are meeting the national low-density cholesterol goal, if data from 105 residents of a New Jersey long-term care facility are typical. In this study, Frank Breve, PharmD, of PharmaTech Consulting Group in Blackwood, N.J., and Dean Giarnarkis, PharmD, an employee of Pfizer Inc., reviewed statin use, cholesterol measures, and heart disease risks for all residents of the facility who received statin prescriptions in 2007. The researchers examined how many residents met their cholesterol goals and compared those numbers and morbidity between residents receiving atorvastatin and simvastatin. The results were in a poster at the AMDAAnnual Symposium. The average age of the residents was 80 years, and 92% had at least one comorbidity, of which hypertension was the most common (78% of all study participants). Most of the residents (62%) had coronary heart disease, diabetes, or another heart disease risk factor. The study participants, all receiving statins, had an average LDL-C of 80 mg/dL. Residents with heart disease and those with two or more risk factors for it showed similarly good LDL-C readings. Although LDL-C goal achievement wasn't significantly different between residents receiving simvastatin and those getting atorvastatin, fewer patients on atorvastatin suffered a stroke (11% vs. 16%) or heart failure (11% vs. 18%) during the study. The average total cholesterol in the residents was 156 mg/dL, which falls in the National Cholesterol Education Program (NCEP) “desirable” range below 200 mg/dL. Similarly, the average HDL cholesterol was 46 mg/dL (in the target range of 40–60 mg/dL). The average triglycerides reading, at 152 mg/dL, was slightly higher than the NCEP “normal” concentration (less than 150 mg/dL). Although the results were limited by a lack of data on interactions between the statins and other drugs that the residents were receiving, the findings should help clinicians achieve the best possible cholesterol outcomes with statins, the researchers said. Pfizer is the maker of atorvastatin, and the company supported this study by supplying data analysis. The real question here is just how important “cholesterol outcomes” are in our patients. Obviously, there are some who clearly benefit, but probably the average 90-year-old hypertensive doesn't really need a statin in the absence of other compelling indications. Certainly, the fact that statins work at reducing cholesterol to “goal” levels is unsurprising. This article doesn't address two pesky geriatric concerns: interactions and adverse effects.