Bach RG, et al. - Through a secondary analysis of the Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT), which recruited 18,144 adults aged 75 years or older with stabilized acute coronary syndrome (ACS), researchers ascertained the impact on outcomes and risks of combination ezetimibe and simvastatin vs simvastatin monotherapy to lower lipid levels. Treatment with simvastatin-ezetimibe led to lower rates of the primary endpoint in comparison with simvastatin-placebo for adults younger than 65 years and for adults aged 65 to 74 years (0.9% and 0.8%, respectively), with the greatest absolute risk reduction of 8.7% for adults aged 75 years or older. Amongst younger or older adults, the rate of adverse events did not progress with simvastatin-ezetimibe in contrast with the simvastatin-placebo. Hence, adults hospitalized for ACS derived benefit from higher-intensity therapy to lower lipid levels with simvastatin-ezetimibe vs simvastatin monotherapy, with the largest absolute risk decline in adults aged 75 years or older. Among older adults, the adding of ezetimibe to simvastatin had no correlation with a vital increase in safety concerns. Moreover, in older adults, these outcomes may have implications for guideline recommendations concerning the lowering of lipid levels.