1. An 88 years old lady came for her annual health visit and enquired about being started on a statin. She has a strong family history of coronary artery disease but herself has been normal till now. The point to be considered before starting her on statin therapy for prevention of coronary artery disease is:

1. Statins are not effective for primary prevention of coronary artery disease in the elderly
2. A healthy individual should not be denied of statin therapy based purely on the age.
3. Statins should be reserved for secondary prevention of coronary artery disease in the elderly
4. Statin effect in the elderly is dependent on the LDL levels.

Answer: Studies have shown that a healthy individual should not be denied  statin therapy based purely on age. There appears to be ample evidence supporting the use of lipid-lowering therapy for secondary prevention in elderly patients with established CHD who do not have life-limiting comorbid disease. A patient with a limited life span from a concomitant illness is probably not a candidate for drug therapy.