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![Noteworthy Comment: Bhardwaj et al. reviewed an important and timely topic on muscular effects of statins in the elderly. This subject is very current since statins provide substantial benefits in support of cardiovascular health, specifically by preventing coronary artery disease and stroke. As a result, statins have become some of the most widely prescribed drugs both in the USA and around the world. However, as with most drugs, clinical problems are associated with their use. One major concern is statin-induced myopathy ranging from a generally painless increases in serum creatinine kinase to myalgia and in the extreme, to rhabdomyolysis whereby myocyte loss and death may occur. Because one of the common effects of aging is muscle loss, it has been recommended that statin therapy should be employed with great caution in elderly persons, particularly in older, thin or frail women.
This review collates and discusses statin-related muscular effects, examines their molecular and genetic basis, and suggests how these apply specifically to the aged. Developing strategies to reduce the incidence of statin-induced myopathy in older patients, especially women, could contribute to a significant reduction in the overall incidence of statin-induced muscle disorder in this vulnerable group. Reducing statin-related muscle disorders would likely improve overall patient compliance, thereby leading to an increase in improved short and long-term outcomes associated with appropriate use of statins. This review takes one step forward towards meeting this therapeutic objective in middle aged and elderly patients.](assets/img/article_icons/noteworthy.png)
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Muscular effects of statins in the elderly female: a review
Authors Bhardwaj S, Selvarajah S, Schneider E
Received 3 November 2012
Accepted for publication 11 December 2012
Published 18 January 2013 Volume 2013:8 Pages 47—59
DOI https://doi.org/10.2147/CIA.S29686
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Shilpa Bhardwaj,1,2 Shalini Selvarajah,3 Eric B Schneider3
1Griffin Hospital, Derby, CT, USA; 2Yale University, New Haven, CT, USA; 3Center for Surgical Trials and Outcomes Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
Abstract: Statins have demonstrated substantial benefits in supporting cardiovascular health. Older individuals are more likely to experience the well-known muscle-related side effects of statins compared with younger individuals. Elderly females may be especially vulnerable to statin-related muscle disorder. This review will collate and discuss statin-related muscular effects, examine their molecular and genetic basis, and how these apply specifically to elderly women. Developing strategies to reduce the incidence of statin-induced myopathy in older adult women could contribute to a significant reduction in the overall incidence of statin-induced muscle disorder in this vulnerable group of patients. Reducing statin-related muscle disorder would likely improve overall patient compliance, thereby leading to an increase in improved short- and long-term outcomes associated with appropriate use of statins.
Keywords: statins, older adults, elderly, females, epidemiology
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