Abstract：
BACKGROUND: Age is a major risk factor for atherosclerotic cardiovascular disease (CVD) and death, but there has been a debate about benefit-risk of statin treatment in the elderly with limited evidence on benefits for primary prevention, while there is strong evidence for its use in secondary prevention.
OBJECTIVE: The aim of this study was to provide an overview of statin utilization in primary and secondary prevention for patients 75-84 years and ≥ 85 years in the Swedish capital Region Stockholm in 2019.
METHODS: This is a cross-sectional study based on the regional healthcare database VAL containing all diagnoses and dispensed prescription drugs for all 174,950 inhabitants ≥ 75 years old in the Stockholm Region. Prevalence and incidence were analyzed by sex, age, cardiovascular risk, substance, and the intensity of treatment.
RESULTS: A total of 35% of all individuals above the age of 75 in the region were treated with statins in 2019. The overall incidence in this age group was 31 patients per 1000 inhabitants. Men, individuals 75-84 compared to ≥ 85 years of age, and those with higher cardiovascular risk were treated to a greater extent. Simvastatin was used primarily by prevalent users and atorvastatin by incident users. The majority was treated with moderate-intensity dosages and fewer women received high intensity treatment.
CONCLUSIONS: Statins are widely prescribed in the elderly. Physicians seem to consider individual cardiovascular risk when deciding to initiate statin treatment for elderly patients, but here may still be some undertreatment among high-risk patients (especially women and elderly 85 + years) and some overtreatment among patients with low-risk for CVD.
OBJECTIVE: The aim of this study was to provide an overview of statin utilization in primary and secondary prevention for patients 75-84 years and ≥ 85 years in the Swedish capital Region Stockholm in 2019.
METHODS: This is a cross-sectional study based on the regional healthcare database VAL containing all diagnoses and dispensed prescription drugs for all 174,950 inhabitants ≥ 75 years old in the Stockholm Region. Prevalence and incidence were analyzed by sex, age, cardiovascular risk, substance, and the intensity of treatment.
RESULTS: A total of 35% of all individuals above the age of 75 in the region were treated with statins in 2019. The overall incidence in this age group was 31 patients per 1000 inhabitants. Men, individuals 75-84 compared to ≥ 85 years of age, and those with higher cardiovascular risk were treated to a greater extent. Simvastatin was used primarily by prevalent users and atorvastatin by incident users. The majority was treated with moderate-intensity dosages and fewer women received high intensity treatment.
CONCLUSIONS: Statins are widely prescribed in the elderly. Physicians seem to consider individual cardiovascular risk when deciding to initiate statin treatment for elderly patients, but here may still be some undertreatment among high-risk patients (especially women and elderly 85 + years) and some overtreatment among patients with low-risk for CVD.
摘要：
背景：年龄是动脉粥样硬化性心血管疾病（CVD）和死亡的主要危险因素，但是关于他汀类药物治疗在老年人中的获益-风险一直存在争议，关于一级预防益处的证据有限，虽然有强有力的证据表明其用于二级预防。
目的：本研究的目的是概述2019年瑞典首都斯德哥尔摩地区75-84岁和≥85岁患者在一级和二级预防中他汀类药物的使用情况。
方法：这是一项基于区域医疗保健数据库VAL的横断面研究，其中包含斯德哥尔摩地区所有174,950名≥75岁居民的所有诊断和分配处方药。患病率和发病率按性别进行分析，年龄,心血管风险，实质,以及治疗的强度。
结果：2019年，该地区75岁以上的所有个体中有35％接受了他汀类药物治疗。该年龄组的总发病率为每1000名居民31名患者。男人,与年龄≥85岁的人相比，75-84岁的人，心血管风险较高的患者接受了更大程度的治疗.辛伐他汀主要由流行使用者使用，阿托伐他汀由事件使用者使用。大多数患者接受中等强度剂量治疗，接受高强度治疗的女性较少。
结论：他汀类药物广泛用于老年人。医生在决定开始他汀类药物治疗老年患者时，似乎会考虑个体的心血管风险。但在高危患者(尤其是女性和85岁以上的老年人)中,仍可能存在治疗不足,而在低CVD风险患者中,仍可能存在治疗过度.
目的：本研究的目的是概述2019年瑞典首都斯德哥尔摩地区75-84岁和≥85岁患者在一级和二级预防中他汀类药物的使用情况。
方法：这是一项基于区域医疗保健数据库VAL的横断面研究，其中包含斯德哥尔摩地区所有174,950名≥75岁居民的所有诊断和分配处方药。患病率和发病率按性别进行分析，年龄,心血管风险，实质,以及治疗的强度。
结果：2019年，该地区75岁以上的所有个体中有35％接受了他汀类药物治疗。该年龄组的总发病率为每1000名居民31名患者。男人,与年龄≥85岁的人相比，75-84岁的人，心血管风险较高的患者接受了更大程度的治疗.辛伐他汀主要由流行使用者使用，阿托伐他汀由事件使用者使用。大多数患者接受中等强度剂量治疗，接受高强度治疗的女性较少。
结论：他汀类药物广泛用于老年人。医生在决定开始他汀类药物治疗老年患者时，似乎会考虑个体的心血管风险。但在高危患者(尤其是女性和85岁以上的老年人)中,仍可能存在治疗不足,而在低CVD风险患者中,仍可能存在治疗过度.
