Preprint · Apr 19, 2023

Efficacy and safety of statins and ezetimibe in primary prevention of cardiovascular disease in the elderly: A systematic review protocol. v1

By Fernandez-Gonzalez J

Cardiovascular diseases (CVD) are the leading cause of death globally (1). The risk increases withage. Statins and ezetimibe are indicated for the prevention of CVD and its efficacy in secondaryprevention (patients who have had an adverse CVD event) has been demonstrated in all agegroups (2). However, there is controversy about its use in primary prevention (people withoutestablished CVD) in the elderly (3, 4), since the patients older than 75 years are a group ofunderrepresented population in clinical trials. This age threshold has been used in meta-analysisof randomized controlled trials that did not shown evidence of an effect in cardiovascular eventsin people older than 75 years without vascular disease (5–7) . The latest clinical guidelinespublished in the United States and Europe differ notably in their recommendations (8–10). As other medicines, statins and ezetimibe are not exempt from adverse events. These are morefrequent in geriatric patients, since comorbidities and polypharmacy frequently coexist. Thesefactors can increase the risk of drug interactions and contribute to the impairment of renal andhepatic function (11). We describe a protocol for a systematic review that will evaluate the effectiveness and safety ofstatins and ezetimibe in people over 75 years of age.

doi.org/10.17504/protocols.io.4r3l27k7qg1y/v1Open accessInterventions