Pravastatin experience in elderly and non-elderly patients

• Published in: Atherosclerosis Vol. 101; no. 1; p. 97
• Main Authors: Mellies, M J, DeVault, A R, Kassler-Taub, K, McGovern, M E, Pan, H Y
• Format: Journal Article
• Language: English
• Published: Ireland 01-06-1993
• Subjects: Adult; Age Factors; Aged; Cholesterol - blood; Female; Humans; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Male; Middle Aged; Pravastatin - administration & dosage; Pravastatin - adverse effects; Pravastatin - therapeutic use; Triglycerides - blood
• ISSN: 0021-9150
• DOI: 10.1016/0021-9150(93)90105-4

Epidemiologic evidence linking elevated cholesterol concentrations and coronary heart disease (CHD) through the eighth decade of life provides a rationale for lowering cholesterol concentrations to reduce morbidity and mortality from CHD. Pravastatin, a well tolerated HMG CoA reductase inhibitor with a convenient once-daily dosing regimen, has been shown to effectively lower total and low density lipoprotein (LDL) cholesterol. Individual data from more than 1800 hypercholesterolemic patients enrolled in six double-blind, randomized, multicenter studies were pooled and then analyzed to compare the safety and efficacy of pravastatin in the elderly (i.e., patients at least 65 years old) and the non-elderly. In short-term studies (8-16 weeks), response was dose-related and similar in elderly and non-elderly subjects. Pravastatin 20 or 40 mg daily lowered total cholesterol 19-25%, LDL-cholesterol 25-33%, and triglycerides 14-23%; high density lipoprotein (HDL) cholesterol increased 5-10%. During long-term studies, improvements were sustained for more than 24 months in both the non-elderly and elderly. The incidences of adverse drug events and laboratory abnormalities were similar in the elderly and non-elderly patients in all groups (active treatment control with resin, pravastatin alone, or combination therapy). In short-term studies, treatment was discontinued because of adverse events in < 1% of all patients treated with pravastatin (all doses) or placebo. The frequency and profile of adverse events were similar among patients treated with pravastatin or placebo. In long-term studies, treatment was discontinued in 0.4% of patients in the pravastatin group and in 0.3% of the patients in the bile-acid-binding resin group. If drug therapy is warranted, pravastatin appears to be safe and effective for long-term use in elderly patients with hypercholesterolemia.