「高齢者脂質異常症 診療 ... - jpn-geriat-soc.or.jp

1 2017 3 2017 2017 10 doi: J-STAGE 2017 10 26 GUIDELINEGUIDELINE CQ1 CQ2 CQ3 CQ4 ADL CQ5 E4 ADL CQ6 ADL CQ7 LDL CQ8 CQ9 HDL CQ10 E4 CQ11 CQ12 CQ13 GUIDELINE 1 Clinical Question CQ CQ 23 25 ADL CQ Question Q CQ Q CQ 2 CQ PubMed Cochrane

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3 MSD GUIDELINEGUIDELINE 2017 CQ1 Non HDL LDL CQ2 A 75 LDL-C A 75 LDL-C CQ3 B CYP B CQ4 ADL TG HDL ADL CQ5 E4 ADL E4 ADL CQ6 ADL ADL B CQ7 LDL LDL CQ8 CQ9 HDL HDL CQ10 E4 E4 CQ11 A CQ12 CQ13 1 QOL B GUIDELINE Non HDL LDL 65 75 LDL 1 6 1 75 LDL 7 9 2 10 65.

4 594 EPOCH-JAPAN 70 89 240 mg/dl 10 1 Non HDL NIPPON DATATA 90 65 Non HDL 11 2 90 61 55,000 70 89 12 1 29 60 60 74 75 13 1 Cardiovascular Health Study 65 HDL LDL non HDL 14 Cardiovascular Health Study 65 74 75 84 85 3 65 74 HDL 15 2 65 Non HDL LDL 1 Barrett-Connor E, Suarez L, Khaw K, Criqui MH, Wingard DL: Ischemic heart disease risk factors after age 50.

5 J Chronic Dis 1984; 37 (12): 903 908. 2 Benfante R, Reed D: Is elevated serum cholesterol level a risk factor for coronary heart disease in the elderly? JAMA 1990; 263 (3): 393 396. 3 Corti MC, Guralnik JM, Salive ME, Harris T, Ferrucci L, Glynn RJ, et al: Clarifying the direct relation between total cholesterol levels and death from coro-nary heart disease in older persons. Ann Intern Med 1997; 126 (10): 753 760. 4 Harris T, Cook EF, Kannel WB, Goldman L: Propor-tional hazards analysis of risk factors for coronary heart disease in individuals aged 65 or older. The Framingham Heart Study. J Am Geriatr Soc 1988; 36 (11): 1023 1028. 5 Pacala JT: The relation of serum cholesterol to risk of coronary heart disease: implications for the elderly. J Am Board Fam Pract 1990; 3 (4): 271 282. 6 Rubin SM, Sidney S, Black DM, Browner WS, Hulley SB, Cummings SR: High blood cholesterol in elderly men and the excess risk for coronary heart disease.

6 Ann Intern Med 1990; 113 (12): 916 920. 7 Kronmal RA, Cain KC, Ye Z, Omenn GS: Total serum GUIDELINEGUIDELINE 2017 levels and mortality risk as a function of age. A report based on the Framingham data. Arch Intern Med 1993; 153 (9): 1065 1073. 8 Krumholz HM, Seeman TE, Merrill SS, Mendes de Leon CF, Vaccarino V, Silverman DI, et al: Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortal-ity in persons older than 70 years. JAMA 1994; 272 (17): 1335 1340. 9 Weverling-Rijnsburger AW, Blauw GJ, Lagaay AM, Knook DL, Meinders AE, Westendorp RG: Total cho-lesterol and risk of mortality in the oldest old. Lancet 1997; 350 (9085): 1119 Nagasawa SY, Okamura T, Iso H, Tamakoshi A, Yamada M, Watanabe M, et al: Relation between serum total cholesterol level and cardiovascular dis-ease stratified by sex and age group: a pooled analy-sis of 65 594 individuals from 10 cohort studies in Japan.

7 J Am Heart Assoc 2012; 1 (5): Ito T, Arima H, Fujiyoshi A, Miura K, Takashima N, Ohkubo T, et al: Relationship between non-high-den-sity lipoprotein cholesterol and the long-term mortal-ity of cardiovascular diseases: NIPPON DATA 90. Int J Cardiol 2016; 220: 262 Prospective Studies Collaboration, Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, et al: Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet 2007; 370 (9602): 1829 Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, et al: Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol 2003; 32 (4): 563 Psaty BM, Anderson M, Kronmal RA, Tracy RP, Orchard T, Fried LP, et al: The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The Cardiovas-cular Health Study.

8 J Am Geriatr Soc 2004; 52: 1639 Odden MC, Shlipak MG, Whitson HE, Katz R, Kear-ney PM, defilippi C, et al: Risk factors for cardiovascu-lar disease across the spectrum of older age: the Cardiovascular Health Study. Atherosclerosis 2014; 237: 336 342. 1 50 79 3,187 9 2 65 1,480 12 4 RR 95 CI 65 3 4,066 5 p 4 Framingham Heart Study 65 2,501 200 mg/dl RR 95 CI 5 4 50 2,908 341 60 GUIDELINE 60 79 2,746 20 5 / /1,000 / /1.

9 000 7 Framingham Heart Study 5,209 LDL 80 LDL 8 70 997 HDL 4 HDL 9 85 724 ICD-9 3 mmol/l 5 1 mmol/l 15 risk rario 95 CI 10 / 40 89 65,594 70 89 75 mmol/l HR 95 CI 11 NIPPON DATA 90 75 6,701 non-HDL non-HDL non-HDL non-HDL p 12 / 40 89 61 900,000 70 89 1 mmol/l HR 95 CI 13 / 29 352,033 / ICD-9 1 mmol/l GUIDELINEGUIDELINE 2017 Cardiovascular Health Study 65 5,201 LDL LDL HDL HDL 15 Cardiovascular Health Study 65 4.

10 883 65 74 75 84 85 3 5 CQ2 A 75 LDL-C A 75 LDL-C 70 82 PROSPER RCT 65 Roberts 15 95 CI 7 22 23 95 CI 15 29 26 95 CI 22 30 24 95 CI 10 35 1 1 RCT 75 75 CTT 2 1+ 75 PROSPER 3 1 2012 75 4 5 6 1 Roberts CG, Guallar E, Rodriguez A: Efficacy and safety of statin monotherapy in older adults: a meta-analysis.