Cobos-Palacios, LidiaSanz-Cánovas, JaimeMuñoz-Ubeda, MónicaLopez-Carmona, María DoloresPerez-Belmonte, Luis MiguelLopez-Sampalo, AlmudenaGómez-Huelgas, RicardoBernal-Lopez, Maria Rosa2022-10-192022-10-192021-11-29Cobos-Palacios L, Sanz-Cánovas J, Muñoz-Ubeda M, Lopez-Carmona MD, Perez-Belmonte LM, Lopez-Sampalo A, et al. Statin Therapy in Very Old Patients: Lights and Shadows. Front Cardiovasc Med. 2021 Nov 29;8:779044.http://hdl.handle.net/10668/4262Atherosclerotic cardiovascular diseases (ASCVD) are the leading cause of death worldwide. High levels of total cholesterol-and of low-density lipoprotein cholesterol in particular-are one of the main risk factors associated with ASCVD. Statins are first-line treatment for hypercholesterolemia and have been proven to reduce major vascular events in adults with and without underlying ASCVD. Findings in the literature show that statins reduce coronary and cerebrovascular morbidity and mortality in middle-aged people, but their benefits in older adults are not as well-established, especially in primary prevention. Furthermore, many particularities must be considered regarding their use in old subjects, such as age-related changes in pharmacokinetics and pharmacodynamics, comorbidities, polypharmacy, and frailty, which decrease the safety and efficacy of statins in this population. Myopathy and a possible higher risk of falling along with cognitive decline are classic concerns for physicians when considering statin use in the very old. Additionally, some studies suggest that the relative risk for coronary events and cardiovascular mortality associated with high levels of cholesterol decreases after age 70, making the role of statins unclear. On the other hand, ASCVD are one of the most important causes of disability in old subjects, so cardiovascular prevention is of particular interest in this population in order to preserve functional status. This review aims to gather the current available evidence on the efficacy and safety of statin use in very old patients in both primary and secondary prevention.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/StatinsElderlyCardiovascular preventionFrailtyReviewSecondary preventionAtherosclerotic cardiovascular diseasesHypercholesterolemiaPolypharmacyPrimary preventionCholesterolMorbidityInhibidores de hidroximetilglutaril-CoA reductasasAncianoEnfermedades cardiovascularesFragilidadRevisiónPrevención secundariaHipercolesterolemiaPolifarmaciaPrevención primariaColesterolMorbilidadMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Persons::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Persons::Persons::Age Groups::Adult::AgedMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Lipid Regulating Agents::Hypolipidemic Agents::Anticholesteremic Agents::Hydroxymethylglutaryl-CoA Reductase InhibitorsMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Secondary PreventionMedical Subject Headings::Diseases::Cardiovascular DiseasesMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Lipid Metabolism Disorders::Dyslipidemias::Hyperlipidemias::HypercholesterolemiaMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Cause of DeathMedical Subject Headings::Health Care::Environment and Public Health::Public Health::Accidents::Accidental FallsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::PolypharmacyMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Primary PreventionMedical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Cholestanes::Cholestenes::CholesterolMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk FactorsMedical Subject Headings::Diseases::Musculoskeletal Diseases::Muscular DiseasesMedical Subject Headings::Chemicals and Drugs::Lipids::Lipoproteins::Lipoproteins, LDLMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Personnel::PhysiciansMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidityreview article34912868open access10.3389/fcvm.2021.7790442297-055XPMC8667269