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Ezetimibe treatment in the elderly to reduce cardiovascular events

Umidakhon Makhmudova, P Christian Schulze, Oliver Weingartner

Elderly people are the most fragile subgroup among patients with cardiovascular diseases. In patients 75 years and older treatment efficacy with statins is controversially debated. A secondary analysis of IMPROVE-IT demonstrates that adding ezetimibe to simvastatin in patients 75 years and older lowers not only LDL-cholesterol levels, but also cardiovascular events. This stands in line with previous findings that low-cholesterol absorption is associated with better survival and fewer cardiovascular events in elderly patients. These findings further add to the concept of “individualized lipid-lowering therapy”, in which determination of markers of cholesterol metabolism guide a personalized addition of ezetimibe.