Gustavo A. Cardenas, MD, Carl J. Lavie, MD and Richard V. Milani, MD, Department of Cardiology, Ochsner Medical Institutions, New Orleans, LA, USA.

There is growing evidence that risk factors, which predict cardiovascular disease in younger people, are also predictive in older adults. Given the huge burden of cardiovascular disease in this latter population, older adults should not be excluded from primary or secondary prevention strategies, such as management of dyslipidemia. Low levels of high- density lipoprotein cholesterol (HDL-C) have a stronger association with cardiovascular disease than do high levels of low-density lipoprotein cholesterol (LDL-C). This article focuses on the importance of HDL-C as a risk factor for older patients, the evidence that exists supporting this association, the factors associated with low levels of HDL-C, and the mechanisms by which low HDL-C is related to an increased risk of cardiovascular diseases.
Key words: high-density lipoprotein cholesterol, aging, older adults, dyslipidemia, lipoprotein, atherosclerosis, cardiovascular disease.

Lucie Lavoie, MD, FRCP(C), Resident in Geriatrics, Faculty of Medicine, Université Laval, Quebec City, QC.
Claude Gagné, MD, Service of Lipidology, Department of Medicine, Université Laval, Quebec City, QC.

Complications of coronary artery disease are the leading causes of morbidity and mortality in older persons of both sexes. The control of risk factors may prevent, retard and reverse the evolution of atherosclerosis in older adults, as in younger persons. Thus, treatment of hypercholesterolemia should not be negated on the pretext of age. In addition to non-pharmacological approaches, pharmacological tools are available. Recently, ezetimibe, an inhibitor of intestinal cholesterol absorption, has been launched. We will discuss the usefulness and the potential place of this medication for the treatment of hypercholesterolemia in the older population.
Key words: cholesterol absorption inhibitor, ezetimibe, dyslipidemia, atherosclerosis.