Atorvastatin isn't entirely unsuitable for over-70s, but it requires caution due to increased risks of side effects like muscle pain (myopathy), weakness, liver issues, and diabetes, which are amplified by age, frailty, and taking multiple medications. Doctors often use lower doses, monitor closely, and weigh the benefits (cardiovascular protection) against these risks, recognizing that recent evidence shows statins are still effective and safe for most older adults, especially with existing heart disease.
Statins should be taken with caution if you're at an increased risk of developing a rare side effect called myopathy, which is where the tissues of your muscles become damaged and painful. Severe myopathy (rhabdomyolysis) can lead to kidney damage. Things that can increase this risk include: being over 70 years old.
No dose limitation has been suggested for patients taking atorvastatin while they are also taking amlodipine [2]. However, the risk of statin-induced myopathy due to cytochrome p450 inhibitors appears considerably greater when taking lovastatin and simvastatin compared to atorvastatin.
Both the ACC/AHA and US Preventive Services Task Force guidelines clearly state that there are too few data and inadequate evidence in people older than 75 for a strong, risk-based statin recommendation.
Atorvastatin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: diarrhea. heartburn.
Commonly reported atorvastatin side effects include muscle pain, joint pain, and diarrhea. Serious atorvastatin side effects are rare but possible. They include liver, kidney, and severe muscle damage. Atorvastatin can also cause blood glucose (sugar) levels to rise, increasing the risk of diabetes in certain people.
Medications used to treat and prevent heartburn/acid reflux can also interact with statins. These include: Antacids containing magnesium or aluminum hydroxide may decrease the concentration of some statins in the body. This may be prevented by taking your antacid dose at least two hours after your statin dose.
Some of the most common ones include cold symptoms, joint pain or stiffness, muscle pain or weakness, and diarrhea. Side effects can start pretty quickly, though they can also be temporary. Before taking atorvastatin, talk to a healthcare provider about your health history and current medications.
It may be reasonable to initiate statin therapy for primary prevention of atherosclerotic cardiovascular disease (ASCVD) events in patients older than age 75 years who have a low-density lipoprotein (LDL) cholesterol level of 70 to 189 mg/dL and no life-limiting illness, according to a recent expert clinical consensus.
Carimi says it's best to stick with the medication. He says the risk is too high, even if you're now living a better, healthier lifestyle. However, if you haven't had a stroke or heart attack and you are taking statins due to high cholesterol numbers, ending statin use might be an option.
Combining these two treatments may result in anything from less than an additive effect to more than a multiplicative effect on cardiovascular disease risk. Experimental studies have suggested positive8 9 as well as negative10 synergistic effects between blood pressure-lowering drugs and statins.
To make sure it's safe for you, tell your doctor if you: have ever had an allergic reaction to amlodipine or any other medicine. have liver or kidney disease. have heart failure or you have recently had a heart attack.
Amlodipine has demonstrated some anti-atherosclerotic properties, whereas the beneficial effects of atorvastatin on atherosclerosis, via a reduction in cholesterol levels, are more marked.
Additionally, statins should be avoided or used with caution in certain situations. People with liver disease, for example, may be at risk for further liver damage if they take statins. Pregnant women or those trying to conceive are also advised to avoid statins, as they can harm foetal development.
A study of more than 135,000 people at risk for a heart attack or stroke found that those who took statins had a 25% lower risk of having a heart attack or stroke compared to those who did not take statins.
Ideal Levels: A total cholesterol level of 5 mmol/L or lower is generally considered healthy for most adults. Borderline High Levels: Levels between 5 and 6.4 mmol/L are considered borderline high. High Levels: A level of 6.5 mmol/L or above is classified as high and may increase your risk of cardiovascular disease.
Levels of LDL cholesterol higher than 130 milligrams per deciliter (mg/dL) are linked to an increased risk for ischemic stroke.
The worst foods for high cholesterol, given their high saturated fat content, include: Red meat, like beef, pork, and lamb, as well as processed meats like sausage. Full-fat dairy, like cream, whole milk, and butter. Baked goods and sweets.
People aged 70 and older who take statins live longer in good health than those who do not, regardless of whether they have cardiovascular disease, a modelling study found. Both standard and high-intensity treatment was cost-effective in this age group.
have liver or kidney problems. think you might be pregnant, are already pregnant, or you're breastfeeding. have lung disease. have previously had a stroke caused by bleeding into the brain.
Liver damage
Sometimes, statin use could cause an increase in the level of enzymes in the liver. These enzymes signal inflammation. If the increase is only mild, you can continue to take the statin.
Two drugs that can't be taken together include opioids and alcohol, or benzodiazepines and alcohol, as this combination severely slows breathing and increases overdose risk, and also aspirin and ibuprofen (or other NSAIDs), which heighthens the danger of serious bleeding or stomach ulcers, highlighting the importance of checking all medications for dangerous interactions.
Concomitant administration of atorvastatin, omeprazole, and dexamethasone has been shown to increase the serum concentration of serum hydroxymethylglutaryl coenzyme A which can be associated with elevation of creatine kinase and an increased risk of severe myopathy and rhabdomyolysis.
You are likely to be at greater risk of developing type 2 diabetes if you have high levels of sugars and fats in your blood, are overweight and have high blood pressure. There is some evidence that atorvastatin can raise blood sugar in some people. If you are concerned speak to your doctor.