Elder Pharmacology

Diminished function and threat of disease drives the elderly to their doctor. Surely "doctor knows best." At least that is what common "wisdom" dictates.

Let's put some of the threats older folks face and their popular solutions in perspective. 

High cholesterol is supposedly linked to heart disease. Setting aside the fallacy of this assumption, consider this. If we assume that high cholesterol does indeed increase the risk of cardiovascular disease three fold (standard propaganda), surprisingly, simply aging from 35 to 85 increases the risk 1000 fold. 

Anti-cholesterol drugs are increasingly being used by seniors. However, research has proven that this drug class does not decrease overall mortality. In fact, statins increase susceptibility to other diseases, such as diabetes, and mortality from them. 

Obviously, the better course of action is to not get old. Getting on an anti-cholesterol drug bandwagon merely accelerates the aging process. Better to do all you can to retard aging. That requires your personal choices and actions regarding what you can do for yourself, not a doctor's visit. 

(Increasingly we are getting questions about cholesterol test readings in pets. Pets do not get atherosclerosis or die of heart attacks or strokes. The reason for this is explained in my book. Although drug companies would love to expand their market for statins, worrying about cholesterol levels in pets [in the main, humans too], is pointless.) 

Considering cancer, adult onset diabetes, Alzheimer's and other degenerative diseases, even assuming drugs may bring more benefit than harm, aging itself is the greatest risk factor by 100 to 1000 fold. 

Nevertheless, people "see their doctor" and often end up taking multiple medications for multiple conditions. There is no evidence to inform doctors or patients about the safety of such polypharmacological therapy. 

With cardiovascular disease taking such a toll on the population, it and its related pathology, cerebrovascular disease, are in the front of the minds of doctors and patients. The latter is what all the blood pressure hullabaloo is about. You can even get it checked at vending machines in grocery stores and malls. Granted that increased blood pressure may indicate atherosclerosis (hardening of the arteries). But blood pressure medicine, taken by the train load by the elderly, is not the solution. 

In fact, cognitive function in the elderly should be of far more concern. (As discussed in a previous issue.) Unfortunately, as is always the case, pharmaceuticals have their dark side. Studies now show that elevated blood pressure in the elderly improves cognitive function and that blood pressure medication can accelerate its decline. 

Folks, there is no easy way out like taking a drug. It may, as is increasingly being proven to be true, hasten your demise. 

Do the smart thing. Learn how to take care of yourself. With the Internet and the world of information it presents, there is no excuse not to. 

Diabetes Care, 32:1924-29, 2009; Am J Hypertens, 16:818-26, 2003; Amer J Ther, 17:358-64, 2010.