Comparison of lipid modulating effect of two dosages of atorvastatin calcium on patients ≥75 years old with intermediate or high risk stratification for ASCVD

AIM To compare and to evaluate the therapeutic and side effects of low and middle doses of atorvastatin calcium on patients 75 years or older with cardiovascular diseases. METHODS 262 out patients in our hospital ≥75 years with intermediate or high risk stratification for arteriosclerotic cardiovascular diseases (ASCVD) were randomized into low (10 mg/d, 10 mg group, n=119) and middle (20 mg/d, 20 mg group, n=143) doses of atorvastatin calcium treatment groups, which were simultaneously given lifestyle intervention for 12 month. Lipid profile, fasting plasma glucose, liver, and kidney functions were recorded before and after 12 month medication in both groups. RESULTS At baseline, both low and middle atorvastatin calcium groups exhibited almost similar general characters, including gender, age, cardiovascular risk factors, including incidences of hypertension, hyperlipidemia, smoking, lipid profile, fasting blood glucose, liver transaminases, and urea nitrogen. Slightly elevated serum creatinine (in normal range) was elevated in the middle dosage group (P<0.05), but the abnormal incidence of it was similar in the two groups. With 1 year of medication, both doses of atorvastatin calcium significantly decreased levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (P<0.01), in which the middle dosage group reached 54.7% compliance rate compared to 37.6% in the lower dosage group (P<0.01). There were no significant changes in fasting blood glucose, liver transaminases, and urea nitrogen in the two groups. Increased serum creatinine was observed after the administration of atorvastatin calcium in both groups (P<0.05 in 10 mg group, and P<0.01 in 20 mg group), but the abnormal incidence of it showed no differences in successive and different dose treatment in the two groups. CONCLUSION In this comparative study, atorvastatin calcium medication proved to be effective and safe for patients 75 years or older with cardiovascular diseases. Slightly increased serum creatine was observed in both dosing groups of atorvastatin calcium.