Elderly patients claudication

These elfects on cerebrovascular events and on intermittent claudication suggest that simvastatin and other elfective lipid-lowering treatments may have a general antiatherosclerotic elfect not limited to the coronary bed. Definitive evidence on the elfects of statin therapy in stroke prevention and peripheral vessel disease is likely to be provided by the Heart Protection Study (MRC/BHF Heart Protection Study Collaborative Group, 1999). As noted above, this UK study has randomized over 20,000 patients aged up to 80 to simvastatin 40 mg or placebo, and the 5-year treatment period is scheduled for completion in 2001. Among these patients are 3288 patients with a history of cerebrovascular disease. Because of its size and the broad array of patient types randomized, this study should also provide reliable evidence of the elfect of simvastatin on coronary morbidity and mortality in women, elderly patients, patients with low levels of LDL and HDL cholesterol, patients with peripheral vascular disease, and diabetic patients with or without coronary disease (MRC/BHF Heart Protection Study Collaborative Group, 1999). 

Death In a registry-based study of 58 465 Swedish patients with diabetes aspirin significantly increased the risk of death in those without cardiovascular disease (previous or acute myocardial infarction, angina pectoris, ischemic stroke, transient ischemic attack, intermittent claudication, previous coronary artery bypass graft surgery, or percutaneous coronary intervention) by 17% (95% Cl = 1, 36) at age 50 years and by 29% (95% Cl = 16, 43) at age 85 years [70 ]. In elderly patients with diabetes with cardiovascular disease who used aspirin there was a non-significant trend towards reduced mortality, by 11% at age 85 years. The risk of serious bleeding was also increased by aspirin in those without cardiovascular disease and reduced by aspirin in those with cardiovascular disease. 

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