{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:28:02Z","timestamp":1789507682851,"version":"build-2803163510"},"reference-count":54,"publisher":"The Endocrine Society","issue":"5","funder":[{"DOI":"10.13039\/100005709","name":"Endocrine Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005709","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The efficacy of lipid-lowering agents on patient-important outcomes in older individuals is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included randomized trials that enrolled individuals aged 65 years or older and that included at least 1 year of follow-up.<\/jats:p>\n                    <jats:p>Pairs of reviewers selected and appraised the trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 23 trials that enrolled 60,194 elderly patients. For primary prevention, statins reduced the risk of coronary artery disease [CAD; relative risk (RR): 0.79, 95% CI: 0.68 to 0.91] and myocardial infarction (MI; RR: 0.45, 95% CI: 0.31 to 0.66) but not all-cause or cardiovascular mortality or stroke. These effects were imprecise in patients with diabetes, but there was no significant interaction between diabetes status and the intervention effect. For secondary prevention, statins reduced all-cause mortality (RR: 0.80, 95% CI: 0.73 to 0.89), cardiovascular mortality (RR: 0.68, 95% CI: 0.58 to 0.79), CAD (RR: 0.68, 95% CI: 0.61 to 0.77), MI (RR: 0.68, 95% CI: 0.59 to 0.79), and revascularization (RR: 0.68, 95% CI: 0.61 to 0.77). Intensive (vs less-intensive) statin therapy reduced the risk of CAD and heart failure. Niacin did not reduce the risk of revascularization, and fibrates did not reduce the risk of stroke, cardiovascular mortality, or CAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High-certainty evidence supports statin use for secondary prevention in older individuals. Evidence for primary prevention is less certain. Data in older individuals with diabetes are limited; however, no empirical evidence has shown a significant difference based on diabetes status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2019-00195","type":"journal-article","created":{"date-parts":[[2019,3,23]],"date-time":"2019-03-23T09:09:25Z","timestamp":1553332165000},"page":"1585-1594","source":"Crossref","is-referenced-by-count":36,"title":["Lipid-Lowering Agents in Older Individuals: A Systematic Review and Meta-Analysis of Randomized Clinical Trials"],"prefix":"10.1210","volume":"104","author":[{"given":"Oscar J","family":"Ponce","sequence":"first","affiliation":[{"name":"Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota"},{"name":"Unidad de Conocimiento y Evidencia (CONEVID), Universidad Peruana Cayetano Heredia, Lima, Peru"},{"name":"Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Larrea-Mantilla","sequence":"additional","affiliation":[{"name":"Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota"},{"name":"Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Hemmingsen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Herlev University Hospital, Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Serrano","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota"},{"name":"Department of Nutrition, Diabetes and Metabolism, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Rodriguez-Gutierrez","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota"},{"name":"Universidad Autonoma de Nuevo Leon, Hospital Universitario \u201cDr. Jos\u00e9 E. 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Gonzalez,\u201d Plataforma INVEST-KER Mexico, Monterrey, Nuevo Le\u00f3n, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Benkhadra","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Saint Clair Memorial Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R","family":"Gionfriddo","sequence":"additional","affiliation":[{"name":"Center for Pharmacy Innovation and Outcomes, Geisinger, Danville, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry J","family":"Prokop","sequence":"additional","affiliation":[{"name":"Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P","family":"Brito","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5502-5975","authenticated-orcid":false,"given":"Mohammad Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2019,3,23]]},"reference":[{"key":"2020071622384758500_B1","volume-title":"2016 An Aging World","author":"He","year":"2015"},{"key":"2020071622384758500_B2","first-page":"1735","article-title":"Secondary prevention of coronary heart disease in the elderly (with emphasis on patients &gt; or =75 years of age): an American Heart Association scientific statement from the Council on Clinical Cardiology Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention","volume-title":"Circulation","author":"Williams","year":"2002"},{"issue":"5","key":"2020071622384758500_B3","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1111\/jgs.12788_2","article-title":"Aggressive lipid management in very elderly adults: less is more","volume":"62","author":"Rich","year":"2014","journal-title":"J Am Geriatr Soc"},{"key":"2020071622384758500_B4","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1161\/01.cir.0000437738.63853.7a","article-title":"2013 ACC\/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","author":"Stone","year":"2014","journal-title":"Circulation"},{"key":"2020071622384758500_B5","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ejim.2017.12.011","article-title":"Appropriateness of statin prescription in the elderly","volume":"50","author":"Ruscica","year":"2018","journal-title":"Eur J Intern Med"},{"issue":"1","key":"2020071622384758500_B6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jacc.2017.10.080","article-title":"Primary prevention with statins\u00a0in\u00a0the\u00a0elderly","volume":"71","author":"Mortensen","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"2020071622384758500_B7","doi-asserted-by":"crossref","first-page":"e1000100","DOI":"10.1371\/journal.pmed.1000100","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration","volume":"6","author":"Liberati","year":"2009","journal-title":"PLoS Med"},{"key":"2020071622384758500_B8","unstructured":"Murad MH . 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