Health
Dr. Roach: Statins continue to be an effective treatment for most ages | Healthy aging
Dear DR Roach: You seem to be promoting statins. How about statins for the elderly? A recent peer-reviewed and seemingly popular 2017 study found that “pravastatin is beneficial when given to elderly people with moderate hyperlipidemia and hypertension for primary prophylaxis. However, an insignificant direction towards increasing pravastatin-induced mortality was observed. Among adults aged 75 and over. ”Is this an important result? — — RBR
Answer: Statins are recommended for people at high risk of heart disease and stroke, but only after a comprehensive study of all risk factors. In many cases, you can reduce your risk by changing your lifestyle, especially your diet and exercise. In some cases, the risk can be reduced to the point where statins are no longer needed.
Until quite recently, older people were not the subject of much research. On the other hand, we don’t want to treat people without good reason to expect the benefits to outweigh the risks. Older people, on the other hand, are at increased risk of developing vascular disease and its complications.
The 2017 study you cite has been overturned by more recent studies. In a 2019 review of all available trials, elderly people with known cardiovascular disease (arterial obstruction) have significant benefits in reducing the need for procedures such as heart attack, stroke, and bypass surgery. Was shown. A 2020 study of veterans with an average age of 81 years without heart obstruction showed that starting statins in this older group reduced overall mortality by about 25%. Another way to look at it is that about 23 people die annually from cardiovascular causes of statins, and 26 per 1,000 people die annually from cardiovascular causes if statins are not taken. This study was not a clinical trial. It just saw if one doctor put them in statins at an older age.
The higher your risk of heart disease, the more valuable it is to take statins. Recent evidence confirms that this also applies to people over the age of 75. However, the cost of taking statins — including economic costs (much lower than many drugs are currently available as generics), side effects, and potential drug interactions — should be considered. ..
DR. Cockroach writing: A recent column on Trigger Finger has brought a lot of letters, and once again, I learned some new and useful information from my readers. For some readers, putting your hands in hot water (do not get hot enough to burn) and exercising some hands in the water is enough to effectively treat the condition without shots or surgery. I noticed that. Some people were relieved only by physiotherapy.
Your doctor (Dr. SB) points out that readers plan to discuss their condition at their annual wellness visits, and that their annual wellness visits are separate from those that discuss medical issues. Reminded me. Attempting to perform both problem-based visits and wellness checks at the same time can complicate billing. He writes: “At the time the appointment was made, it turned out to be very clear that only preventive services could be addressed. For example,” I can schedule another appointment because of that thumb pain. Do you have any? “He advised me. “Advise patients to make appointments when problems occur and not save them for annual examination.”
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