Skip to main content
Top
Gepubliceerd in: Huisarts en wetenschap 2/2016

01-02-2016 | Beschouwing

Statinetherapie bij 80-plussers: starten of staken?

Auteur: Anna Koning

Gepubliceerd in: Huisarts en wetenschap | Uitgave 2/2016

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Koning AS. Statinetherapie bij 80-plussers: starten of staken? Huisarts Wet 2016;59(2):50-3.
Onderzoek heeft duidelijk aangetoond dat statines het risico op hart- en vaatziekten (HVZ) verminderen. In die onderzoeken zijn echter zelden 80-plussers geïncludeerd.
In deze beschouwing worden de voors en tegens van statinegebruik door 80-plussers tegen elkaar afgewogen. Statines geven een risico op bijwerkingen, zoals leverfunctiestoornissen, een licht verhoogde kans op diabetes mellitus en, vooral, soms ernstige spierklachten. Er is weinig bewijs dat statines zinvol zijn voor 80-plussers zonder HVZ in de voorgeschiedenis. Zulke primaire preventie leidt waarschijnlijk alleen tot een verschuiving van de sterfte aan HVZ naar sterfte aan kanker. Uitzondering zijn 80-plussers met diabetes: bij hen reduceren statines zowel de cardiovasculaire als de totale sterfte. Ook bij 80-plussers met HVZ in de voorgeschiedenis zijn statines bewezen effectief. Bij deze twee categorieën patiënten kan men de NHG-Standaard Cardiovasculair risicomanagement onverkort volgen.
Literatuur
1.
go back to reference Landelijke werkgroep Cardiovasculair risicomanagement. NHG-Standaard Cardiovasculair risicomanagement (tweede herziening). Huisarts Wet 2012;55:1428. Landelijke werkgroep Cardiovasculair risicomanagement. NHG-Standaard Cardiovasculair risicomanagement (tweede herziening). Huisarts Wet 2012;55:1428.
2.
go back to reference Rich MW. Aggressive lipid management in very elderly adults: less is more. J Am Geriatr Soc 2014;62:945-7.CrossRefPubMed Rich MW. Aggressive lipid management in very elderly adults: less is more. J Am Geriatr Soc 2014;62:945-7.CrossRefPubMed
3.
go back to reference Desai DA, Zakaria S, Ouyang P. Initiation of statin therapy: are there age limits? Curr Atheroscler Rep 2012;14:17-25.CrossRefPubMed Desai DA, Zakaria S, Ouyang P. Initiation of statin therapy: are there age limits? Curr Atheroscler Rep 2012;14:17-25.CrossRefPubMed
5.
go back to reference Aslam F, Haque A, Lee LV, Foody J. Hyperlipidemia in older adults. Clin Geriatr Med 2009;25:591-606.CrossRefPubMed Aslam F, Haque A, Lee LV, Foody J. Hyperlipidemia in older adults. Clin Geriatr Med 2009;25:591-606.CrossRefPubMed
6.
go back to reference Strandberg TE, Kolehmainen L, Vuorio A. Evaluation and treatment of older patients with hypercholesterolemia: a clinical review. JAMA 2014;312:1136-44.CrossRefPubMed Strandberg TE, Kolehmainen L, Vuorio A. Evaluation and treatment of older patients with hypercholesterolemia: a clinical review. JAMA 2014;312:1136-44.CrossRefPubMed
7.
go back to reference Jacobs JM, Cohen A, Ein-Mor E, Stessman J. Cholesterol, statins, and longevity from age 70 to 90 years. J Am Med Dir Assoc 2013;14:883-8.CrossRefPubMed Jacobs JM, Cohen A, Ein-Mor E, Stessman J. Cholesterol, statins, and longevity from age 70 to 90 years. J Am Med Dir Assoc 2013;14:883-8.CrossRefPubMed
8.
go back to reference Olafsdottir E, Aspelund T, Sigurdsson G, Thorsson B, Eiriksdottir G, Harris TB, et al. Effects of statin medication on mortality risk associated with type 2 diabetes in older persons: the population-based AGES-Reykjavik Study. BMJ Open 2011;1:e000132.PubMedCentralCrossRefPubMed Olafsdottir E, Aspelund T, Sigurdsson G, Thorsson B, Eiriksdottir G, Harris TB, et al. Effects of statin medication on mortality risk associated with type 2 diabetes in older persons: the population-based AGES-Reykjavik Study. BMJ Open 2011;1:e000132.PubMedCentralCrossRefPubMed
9.
go back to reference Shepherd J, Blauw GJ, Murphy MB, Bollen ELEM, Buckley BM, Cobbe SM, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 2002;360:1623-30.CrossRefPubMed Shepherd J, Blauw GJ, Murphy MB, Bollen ELEM, Buckley BM, Cobbe SM, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 2002;360:1623-30.CrossRefPubMed
10.
go back to reference Glynn RJ, Koenig W, Nordestgaard BG, Shepherd J, Ridker PM. Rosuvastatin for primary prevention in older persons with elevated C-reactive protein and low to average low-density lipoprotein cholesterol levels: exploratory analysis of a randomized trial. Ann Intern Med 2010;152:488-96.PubMedCentralCrossRefPubMed Glynn RJ, Koenig W, Nordestgaard BG, Shepherd J, Ridker PM. Rosuvastatin for primary prevention in older persons with elevated C-reactive protein and low to average low-density lipoprotein cholesterol levels: exploratory analysis of a randomized trial. Ann Intern Med 2010;152:488-96.PubMedCentralCrossRefPubMed
12.
go back to reference Holmes HM, Min LC, Yee M, Varadhan R, Basran J, Dale W, et al. Rationalizing prescribing for older patients with multimorbidity: considering time to benefit. Drugs Aging 2013;30:655-66.PubMedCentralCrossRefPubMed Holmes HM, Min LC, Yee M, Varadhan R, Basran J, Dale W, et al. Rationalizing prescribing for older patients with multimorbidity: considering time to benefit. Drugs Aging 2013;30:655-66.PubMedCentralCrossRefPubMed
13.
go back to reference Newson RS, Felix JF, Heeringa J, Hofman A, Witteman JCM, Tiemeier H. Association between serum cholesterol and noncardiovascular mortality in older age. J Am Geriatr Soc 2011;59:1779-85.CrossRefPubMed Newson RS, Felix JF, Heeringa J, Hofman A, Witteman JCM, Tiemeier H. Association between serum cholesterol and noncardiovascular mortality in older age. J Am Geriatr Soc 2011;59:1779-85.CrossRefPubMed
14.
go back to reference Drewes YM, Poortvliet RKE, Blom JW, De Ruijter W, Westendorp RGJ, Stott DJ, et al. Homocysteine levels and treatment effect in the PROspective Study of Pravastatin in the Elderly at Risk. J Am Geriatr Soc 2014;62:213-21.PubMedCentralCrossRefPubMed Drewes YM, Poortvliet RKE, Blom JW, De Ruijter W, Westendorp RGJ, Stott DJ, et al. Homocysteine levels and treatment effect in the PROspective Study of Pravastatin in the Elderly at Risk. J Am Geriatr Soc 2014;62:213-21.PubMedCentralCrossRefPubMed
15.
go back to reference Poortvliet R, Drewes Y. Homocysteïnespiegel en cardiovasculair risico. Huisarts Wet 2015;58:306-7.CrossRef Poortvliet R, Drewes Y. Homocysteïnespiegel en cardiovasculair risico. Huisarts Wet 2015;58:306-7.CrossRef
16.
go back to reference Tsimihodimos V, Bairaktari E, Tzallas C, Miltiadus G, Liberopoulos E, Elisaf M. The incidence of thyroid function abnormalities in patients attending an outpatient lipid clinic. Thyroid 1999;9:365-8.CrossRefPubMed Tsimihodimos V, Bairaktari E, Tzallas C, Miltiadus G, Liberopoulos E, Elisaf M. The incidence of thyroid function abnormalities in patients attending an outpatient lipid clinic. Thyroid 1999;9:365-8.CrossRefPubMed
17.
go back to reference Becerra A, Bellido D, Luengo A, Piédrola G, De Luis DA. Lipoprotein(a) and other lipoproteins in hypothyroid patients before and after thyroid replacement therapy. Clin Nutr Edinb Scotl 1999;18:319-22.CrossRef Becerra A, Bellido D, Luengo A, Piédrola G, De Luis DA. Lipoprotein(a) and other lipoproteins in hypothyroid patients before and after thyroid replacement therapy. Clin Nutr Edinb Scotl 1999;18:319-22.CrossRef
18.
19.
go back to reference Kasiske BL, Ma JZ, Kalil RS, Louis TA. Effects of antihypertensive therapy on serum lipids. Ann Intern Med 1995;122:133-41.CrossRefPubMed Kasiske BL, Ma JZ, Kalil RS, Louis TA. Effects of antihypertensive therapy on serum lipids. Ann Intern Med 1995;122:133-41.CrossRefPubMed
20.
go back to reference Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther 2008;46:72-83.CrossRefPubMed Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther 2008;46:72-83.CrossRefPubMed
21.
go back to reference Cooke CA, Kirkland SA, Sketris IS, Cox J. The impact of statins on health services utilization and mortality in older adults discharged from hospital with ischemic heart disease: a cohort study. BMC Health Serv Res 2009;9:198.PubMedCentralCrossRefPubMed Cooke CA, Kirkland SA, Sketris IS, Cox J. The impact of statins on health services utilization and mortality in older adults discharged from hospital with ischemic heart disease: a cohort study. BMC Health Serv Res 2009;9:198.PubMedCentralCrossRefPubMed
22.
go back to reference Allen Maycock CA, Muhlestein, Pearson RR, et al. Statin therapy is associated with reduced mortality across all age groups of individuals with significant coronary disease, including very elderly patients. J Am Coll Cardiol 2002;40:1777-85.CrossRefPubMed Allen Maycock CA, Muhlestein, Pearson RR, et al. Statin therapy is associated with reduced mortality across all age groups of individuals with significant coronary disease, including very elderly patients. J Am Coll Cardiol 2002;40:1777-85.CrossRefPubMed
23.
go back to reference Gränsbo K, Melander O, Wallentin L, Lindbäck J, Stenestrand U, Carlsson J, et al. Cardiovascular and cancer mortality in very elderly post-myocardial infarction patients receiving statin treatment. J Am Coll Cardiol 2010;55:1362-9.CrossRefPubMed Gränsbo K, Melander O, Wallentin L, Lindbäck J, Stenestrand U, Carlsson J, et al. Cardiovascular and cancer mortality in very elderly post-myocardial infarction patients receiving statin treatment. J Am Coll Cardiol 2010;55:1362-9.CrossRefPubMed
24.
go back to reference Aronow WS, Ahn C. Incidence of new coronary events in older persons with prior myocardial infarction and serum low-density lipoprotein cholesterol & gt; or = 125 mg/dl treated with statins versus no lipid-lowering drug. Am J Cardiol 2002;89:67-9.CrossRefPubMed Aronow WS, Ahn C. Incidence of new coronary events in older persons with prior myocardial infarction and serum low-density lipoprotein cholesterol & gt; or = 125 mg/dl treated with statins versus no lipid-lowering drug. Am J Cardiol 2002;89:67-9.CrossRefPubMed
25.
go back to reference Foody JM, Rathore SS, Galusha D, Masoudi FA, Havranek EP, Radford MJ, et al. Hydroxymethylglutaryl-CoA reductase inhibitors in older persons with acute myocardial infarction: evidence for an age-statin interaction. J Am Geriatr Soc 2006;54:421-30.PubMedCentralCrossRef Foody JM, Rathore SS, Galusha D, Masoudi FA, Havranek EP, Radford MJ, et al. Hydroxymethylglutaryl-CoA reductase inhibitors in older persons with acute myocardial infarction: evidence for an age-statin interaction. J Am Geriatr Soc 2006;54:421-30.PubMedCentralCrossRef
26.
go back to reference Eaton CB, Lapane KL, Murphy JB, Hume AL. Effect of statin (HMG-Co-A-reductase inhibitor) use on 1-year mortality and hospitalization rates in older patients with cardiovascular disease living in nursing homes. J Am Geriatr Soc 2002;50:1389-95.CrossRefPubMed Eaton CB, Lapane KL, Murphy JB, Hume AL. Effect of statin (HMG-Co-A-reductase inhibitor) use on 1-year mortality and hospitalization rates in older patients with cardiovascular disease living in nursing homes. J Am Geriatr Soc 2002;50:1389-95.CrossRefPubMed
27.
go back to reference Galindo-Ocaña J, Bernabeu-Wittel M, Formiga F, Fuertes-Martín A, Barón-Franco B, Murcia-Zaragoza JM, et al. Effects of renin-angiotensin blockers/inhibitors and statins on mortality and functional impairment in polypathological patients. Eur J Intern Med 2012;23:179-84.CrossRefPubMed Galindo-Ocaña J, Bernabeu-Wittel M, Formiga F, Fuertes-Martín A, Barón-Franco B, Murcia-Zaragoza JM, et al. Effects of renin-angiotensin blockers/inhibitors and statins on mortality and functional impairment in polypathological patients. Eur J Intern Med 2012;23:179-84.CrossRefPubMed
28.
go back to reference Olsson AG, Schwartz GG, Szarek M, Luo D, Jamieson MJ. Effects of high-dose atorvastatin in patients & gt; or = 65 years of age with acute coronary syndrome (from the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering [MIRACL] study). Am J Cardiol 2007;99:632-5.CrossRefPubMed Olsson AG, Schwartz GG, Szarek M, Luo D, Jamieson MJ. Effects of high-dose atorvastatin in patients & gt; or = 65 years of age with acute coronary syndrome (from the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering [MIRACL] study). Am J Cardiol 2007;99:632-5.CrossRefPubMed
29.
go back to reference Stalenhoef A. Klassieke risicofactoren voor hart- en vaatziekten hebben bij ouderen geen voorspellende waarde. Huisarts Wet 2009;52:324-5.CrossRef Stalenhoef A. Klassieke risicofactoren voor hart- en vaatziekten hebben bij ouderen geen voorspellende waarde. Huisarts Wet 2009;52:324-5.CrossRef
30.
go back to reference Barry PJ, Gallagher P, Ryan C, O’mahony D. START (Screening Tool to Alert doctors to the Right Treatment): an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing 2007;36:632-8.CrossRefPubMed Barry PJ, Gallagher P, Ryan C, O’mahony D. START (Screening Tool to Alert doctors to the Right Treatment): an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing 2007;36:632-8.CrossRefPubMed
31.
go back to reference Gnjidic D, Le Couteur DG, Blyth FM, Travison T, Rogers K, Naganathan V, et al. Statin use and clinical outcomes in older men: a prospective population-based study. BMJ Open 2013;3(3). Gnjidic D, Le Couteur DG, Blyth FM, Travison T, Rogers K, Naganathan V, et al. Statin use and clinical outcomes in older men: a prospective population-based study. BMJ Open 2013;3(3).
32.
go back to reference Lynch JE, Henderson NR, Ramage L, McMurdo MET, Witham MD. Association between statin medication use and improved outcomes during inpatient rehabilitation in older people. Age Ageing 2012;41:260-2.CrossRefPubMed Lynch JE, Henderson NR, Ramage L, McMurdo MET, Witham MD. Association between statin medication use and improved outcomes during inpatient rehabilitation in older people. Age Ageing 2012;41:260-2.CrossRefPubMed
35.
go back to reference Szadkowska I, Stanczyk A, Aronow WS, Kowalski J, Pawlicki L, Ahmed A, et al. Statin therapy in the elderly: a review. Arch Gerontol Geriatr 2010;50:114-8.CrossRefPubMed Szadkowska I, Stanczyk A, Aronow WS, Kowalski J, Pawlicki L, Ahmed A, et al. Statin therapy in the elderly: a review. Arch Gerontol Geriatr 2010;50:114-8.CrossRefPubMed
36.
go back to reference Hansen KE, Hildebrand JP, Ferguson EE, Stein JH. Outcomes in 45 patients with statin-associated myopathy. Arch Intern Med 2005;165:2671-6.CrossRefPubMed Hansen KE, Hildebrand JP, Ferguson EE, Stein JH. Outcomes in 45 patients with statin-associated myopathy. Arch Intern Med 2005;165:2671-6.CrossRefPubMed
37.
go back to reference Rosenson RS, Baker SK, Jacobson TA, Kopecky SL, Parker BA, The National Lipid Association’s Muscle Safety Expert Panel null. An assessment by the Statin Muscle Safety Task Force: 2014 update. J Clin Lipidol 2014;8(3 Suppl):S58-71.CrossRefPubMed Rosenson RS, Baker SK, Jacobson TA, Kopecky SL, Parker BA, The National Lipid Association’s Muscle Safety Expert Panel null. An assessment by the Statin Muscle Safety Task Force: 2014 update. J Clin Lipidol 2014;8(3 Suppl):S58-71.CrossRefPubMed
38.
go back to reference Zhang H, Plutzky J, Skentzos S, Morrison F, Mar P, Shubina M, et al. Discontinuation of statins in routine care settings: a cohort study. Ann Intern Med 2013;158:526-34.PubMedCentralCrossRefPubMed Zhang H, Plutzky J, Skentzos S, Morrison F, Mar P, Shubina M, et al. Discontinuation of statins in routine care settings: a cohort study. Ann Intern Med 2013;158:526-34.PubMedCentralCrossRefPubMed
39.
go back to reference Jukema JW, Cannon CP, De Craen AJM, Westendorp RGJ, Trompet S. The controversies of statin therapy: weighing the evidence. J Am Coll Cardiol 2012;60:875-81.CrossRef Jukema JW, Cannon CP, De Craen AJM, Westendorp RGJ, Trompet S. The controversies of statin therapy: weighing the evidence. J Am Coll Cardiol 2012;60:875-81.CrossRef
40.
go back to reference Preiss D, Seshasai SRK, Welsh P, Murphy SA, Ho JE, Waters DD, et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA 2011;305:2556-64.CrossRefPubMed Preiss D, Seshasai SRK, Welsh P, Murphy SA, Ho JE, Waters DD, et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA 2011;305:2556-64.CrossRefPubMed
41.
go back to reference Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, De Craen AJM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet 2010;375:735-42.CrossRefPubMed Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, De Craen AJM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet 2010;375:735-42.CrossRefPubMed
42.
go back to reference McGuinness B, Craig D, Bullock R, Malouf R, Passmore P. Statins for the treatment of dementia. Cochrane Database Syst Rev 2014;7:CD007514.PubMed McGuinness B, Craig D, Bullock R, Malouf R, Passmore P. Statins for the treatment of dementia. Cochrane Database Syst Rev 2014;7:CD007514.PubMed
Metagegevens
Titel
Statinetherapie bij 80-plussers: starten of staken?
Auteur
Anna Koning
Publicatiedatum
01-02-2016
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Huisarts en wetenschap / Uitgave 2/2016
Print ISSN: 0018-7070
Elektronisch ISSN: 1876-5912
DOI
https://doi.org/10.1007/s12445-016-0041-0

Andere artikelen Uitgave 2/2016

Huisarts en wetenschap 2/2016 Naar de uitgave

Geschiedenis huisartsgeneeskunde

Emancipatie van de huisdokter