New guidelines released for managing hypercholesterolemia in adults over 75

The National Lipid Association (NLA) and the American Geriatrics Society (AGS) have released a Joint Scientific Statement focused on the management of hypercholesterolemia in adults older than 75 years who do not have a history of atherosclerotic cardiovascular disease (ASCVD).  Published in the Journal of the American Geriatrics Society and the Journal of Clinical Lipidology, this collaborative effort, developed by a diverse team of clinical lipidologists, cardiologists, geriatricians, and pharmacists, offers evidence-based guidance to help clinicians navigate the complexities of cholesterol management in a growing population of older adults.

Older persons have many competing medical and social needs, so treating high cholesterol in those without cardiovascular disease may not always be straightforward for clinicians and patients. We hope to help provide as much clarity as possible."

Vera Bittner, MD, MSPH, MNLA, co-chair of the scientific statement

The statement reviews the current evidence surrounding lipid-lowering therapies in older individuals without established ASCVD and offers pragmatic recommendations to support clinical decision-making in this unique population.

"The AGS is excited to have aligned our efforts with NLA to ensure that lipid management for adults over 75 years of age is personalized, evidence-based, and mindful of the diverse needs of our aging population," added Sunny Linnebur, PharmD, co-chair of the statement.

As the U.S. population continues to age, the number of individuals over 75 years old living without diagnosed cardiovascular disease is growing. However, the decision to initiate or continue cholesterol-lowering therapy in these patients can be challenging due to limited clinical trial data, the presence of comorbidities, polypharmacy, and differing goals of care.

This statement serves as a critical resource to guide personalized treatment decisions-balancing potential benefits in ASCVD prevention with the realities of aging and the end-of-life, frailty, medication burden, and patient preferences.