The aging of the U.S. population will have long term effects on health care delivery in the United States. By the year 2000, the U.S. Bureau of Census projects that the number of persons over age 65 will reach 35 million and by 2050, nearly 70 million. the most disabling medical problem in older Americans is cardiovascular disease which currently affects more than 3.6 millions older Americans. Elevated serum cholesterol, a primary risk factor for heart disease, occurs in 30% of men and 40% of women aged 65-75. While cholesterol lowering has been shown to reduce cardiovascular risk in individuals under age 60, no studies have been done in individuals 60-75 years of age. The advent of lovastatin, with its ease of use, low level of side effects, and powerful ability to lower LDL, now makes such a study of cholesterol lowering possible in the elderly. The enclosed proposal outlines a double-blind, randomized pilot study which will test the feasibility of conducting a collaborative, long term, clinical trial of the effects of aggressive implications for health care in the future. If cholesterol lowering is found to reduce cardiovascular risk in the elderly, millions of older Americans can be treated for high cholesterol and spared premature death and disability. If cholesterol lowering does not reduce cardiovascular morbidity and mortality, millions of older Americans and the health care budget of the nation will be spared the inconvenience and costs of treatment which is not beneficial. Given the aging of the nation, such findings will have profound implications for the future.
